TY - JOUR
T1 - Efficacy and Safety of Psychostimulants for Alzheimer's Disease
T2 - A Systematic Review and Meta-Analysis
AU - Kishi, Taro
AU - Sakuma, Kenji
AU - Iwata, Nakao
N1 - Funding Information:
This study was supported by an unrestricted grant from Daiichi San-kyo. Daiichi Sankyo had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors declare no conflicts of interest.
Publisher Copyright:
© 2020 Georg Thieme Verlag. All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Introduction Several reports of the effectiveness of the use of psychostimulants for the treatment of Alzheimer's disease (AD) are available. Methods A systematic review and meta-analysis was conducted including double-blind, randomized, placebo-controlled trials. Outcomes were the improvement of apathy scales score (primary), mini-mental state examination (MMSE) score, activities of daily living scale score, Zarit burden interview score, all-cause discontinuation, discontinuation due to adverse events, and incidence of at least 1 adverse event. Results Three methylphenidate studies and 1 modaï nil study were identified (n=156). Results from combined psychostimulants were superior to placebo in the improvement of apathy scales score (standardized mean differences [SMD]=-0.63 (-1.22, -0.04), p=0.04, all studies) and the MMSE score (SMD=-0.58 (-1.14, -0.02), p=0.04, 3 methylphenidate studies). The modaï nil study was excluded from the meta-analysis for the improvement of apathy scales score; therefore, the effect size increased (SMD=-0.82 (-1.43, -0.20), p=0.009). However, no significant differences were observed in terms of other outcomes, including safety outcomes between the treatment groups. Discussion Methylphenidate would be effective in treating apathy and cognitive impairment in AD patients.
AB - Introduction Several reports of the effectiveness of the use of psychostimulants for the treatment of Alzheimer's disease (AD) are available. Methods A systematic review and meta-analysis was conducted including double-blind, randomized, placebo-controlled trials. Outcomes were the improvement of apathy scales score (primary), mini-mental state examination (MMSE) score, activities of daily living scale score, Zarit burden interview score, all-cause discontinuation, discontinuation due to adverse events, and incidence of at least 1 adverse event. Results Three methylphenidate studies and 1 modaï nil study were identified (n=156). Results from combined psychostimulants were superior to placebo in the improvement of apathy scales score (standardized mean differences [SMD]=-0.63 (-1.22, -0.04), p=0.04, all studies) and the MMSE score (SMD=-0.58 (-1.14, -0.02), p=0.04, 3 methylphenidate studies). The modaï nil study was excluded from the meta-analysis for the improvement of apathy scales score; therefore, the effect size increased (SMD=-0.82 (-1.43, -0.20), p=0.009). However, no significant differences were observed in terms of other outcomes, including safety outcomes between the treatment groups. Discussion Methylphenidate would be effective in treating apathy and cognitive impairment in AD patients.
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U2 - 10.1055/a-1076-8228
DO - 10.1055/a-1076-8228
M3 - Review article
C2 - 32000270
AN - SCOPUS:85084177066
SN - 0176-3679
VL - 53
SP - 109
EP - 114
JO - Pharmacopsychiatry
JF - Pharmacopsychiatry
IS - 3
ER -