TACRINE EFFICACY IN LEWY BODY DEMENTIA

Background. Response to tacrine varies among patients with Alzheimer's disease (AD). Lewy body dementia (LBD) could be a high responder subt ype of AD. The aim of the study was to compare the effects of tacrine in LED and AD. Methods. Seventy-five consecutive outpatients with mild or moderate AD were screened. Tacrine was given at a dose of 40 mg/da y during 6 weeks. During the next 6 weeks, the patients were treated w ith 80 mg/day and afterwards with 120 mg/day. Patients were assessed a t baseline and treated with a dose of 120 mg/day tacrine for 2 weeks. Results. Analysis was performed on 39 patients (AD, N = 20; LED, N = 1 9). Eight patients were lost to follow-up, eight patients manifested w ith side-effects, six suffered from an intercurrent somatic disease du ring the study and 14 patients had poor compliance or were treated wit h incompatible drugs. Twenty-two patients (11 AD/11 LED) increased the ir cognitive performances with tacrine. Among the 22 patients, the imp rovement differed between the AD and the LED groups. In AD, conceptual ization improved; in LED, the improvements occurred in verbal initiati on and digit span. Conclusion. This study emphasizes the importance of using appropriate tests to determine the positive effects of pharmaco logical treatments. (C) 1998 John Whey & Sons, Ltd.