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. 2011 Jan;1(1):212-27.
doi: 10.1159/000330032. Epub 2011 Jul 20.

The efficacy of licensed-indication use of donepezil and memantine monotherapies for treating behavioural and psychological symptoms of dementia in patients with Alzheimer's disease: systematic review and meta-analysis

I A Lockhart  1 , M E Orme, S A Mitchell
Affiliations

The efficacy of licensed-indication use of donepezil and memantine monotherapies for treating behavioural and psychological symptoms of dementia in patients with Alzheimer's disease: systematic review and meta-analysis

I A Lockhart et al. Dement Geriatr Cogn Dis Extra. 2011 Jan.

Abstract

Background/aims: Behavioural and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) greatly increase caregiver burden. The abilities of donepezil and memantine to manage BPSD within their licensed indications in AD were compared.

Methods: A systematic review, random effects meta-analysis and Bucher indirect comparison were conducted.

Results: Six randomised controlled studies (4 donepezil and 2 memantine) reported use within the licensed indication and had Neuropsychiatric Inventory (NPI) data suitable for meta-analysis. BPSD showed significant improvement with donepezil compared with placebo [weighted mean difference (WMD) in NPI -3.51, 95% confidence interval (CI) -5.75, -1.27], whereas this was not the case for memantine (WMD -1.65, 95% CI -4.78, 1.49). WMD in NPI for donepezil versus memantine favoured donepezil but was not statistically significant (-1.86, 95% CI -5.71, 1.99; p = 0.34).

Conclusion: Within its licensed indication, donepezil is efficacious for the management of BPSD in AD compared with placebo.

Keywords: Alzheimer disease; Behavioural medicine; Behavioural/psychiatric symptoms of dementia; Community Mental Health Services; Geriatric psychiatry; Home nursing; Meta-analysis; Preventive psychiatry; Systematic reviews.

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Figures

Fig. 1
Fig. 1
Flow chart of inclusions/exclusions.
Fig. 2
Fig. 2
Funnel plot of mean difference (MD) in NPI score (LOCF) plotted against standard error.
Fig. 3
Fig. 3
Forest plot of random-effect meta-analysis for studies reporting use in licensed indication: donepezil, mild to moderately severe AD population, and memantine monotherapy, moderate to severe AD population. Note: ChEIs are also used in the placebo control arm; I2 = Variation in effect attributable to heterogeneity.
See this image and copyright information in PMC

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