[A version of this abstract appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 1 Issue 9, April 2011].
Note: The long-awaited review and re-appraisal of Donepezil, Galantamine, Rivastigmine and Memantine for the treatment of Alzheimer’s Disease has resulted in changes to previous guidance.
The three acetylcholinesterase (AChE) inhibitors; Donepezil, Galantamine and Rivastigmine are now recommended as options for managing mild as well as moderate Alzheimer’s disease.
Memantine is now recommended as an option for managing moderate Alzheimer’s Disease for people who cannot take AChE inhibitors, and is also an option for managing severe Alzheimer’s disease.
Note: These updates have also been reflected in the main NICE-SCIE Dementia Guideline.
“Only specialists in the care of patients with dementia (that is, psychiatrists including those specialising in learning disability, neurologists, and physicians specialising in the care of older people) should initiate treatment. Carers’ views on the patient’s condition at baseline should be sought.
Treatment should be continued only when it is considered to be having a worthwhile effect on cognitive, global, functional or behavioural symptoms.
Patients who continue on treatment should be reviewed regularly using cognitive, global, functional and behavioural assessment. Treatment should be reviewed by an appropriate specialist team, unless there are locally agreed protocols for shared care. Carers’ views on the patient’s condition at follow-up should be sought”.
National Institute for Health and Clinical Excellence, (2011). NICE Technology Appraisal Guidance TA217. Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease (review of NICE technology appraisal guidance 111). London: NICE, March 23rd 2011.