GUIDELINES FOR THE USE OF TACRINE IN ALZHEIMERS-DISEASE - CLINICAL-APPLICATION AND EFFECTIVENESS

The efficacy of tacrine for treatment of Alzheimer's has been demonstr ated in several clinical trials but has not been assessed in cases com plicated by medical and psychiatric comorbidities. Additionally, the b enefit-risk ratio of tacrine is small, so if is best administered with carefully developed guidelines that specify this ratio for patients a nd families. On the basis of guidelines developed for the Johns Hopkin s Dementia Research Clinic, tacrine treatment was offered to 162 patie nts with probable Alzheimer's. Only 35 accepted, and only 22 continued on tacrine beyond 3 months. The latter group declined by 1.36 points over 1 year on the Mini-Mental State Examination, significantly less t han expected. The authors conclude that, if used in the context of cli nical guidelines, tacrine is an effective treatment for Alzheimer's.