Rivastigmine in the treatment of dementia with Lewy bodies: Preliminary findings from an open trial

The objective of this study was to assess the tolerability and efficacy of rivastigmine in a group of patients with probable dementia with Lewy bodies (DLB), using an open label study. Open label treatment was with rivastigmi ne up to maximum tolerated dose (mean 9.6 mg daily, range 3-12 mg). Eleven patients with DLB, mean age 78.5 years, were treated with this cholinestera se inhibitor. After 12 weeks of treatment, mean Neuropsychiatric Inventory scores fell by 73% for delusions, 63% for apathy, 45% for agitation and 27% for hallucinations. Five of the patients (45%) experienced very significan t clinical improvements that had not been achieved with other treatments, i ncluding low dose neuroleptics. Medication was well tolerated and parkinson ian symptoms tended to improve. Cholinesterase inhibition may be a safe and effective alternative to neuroleptic treatment in DLB. Such effects may al so prove to be applicable to the management of neuropsychiatric symptoms in Parkinson's disease and Alzheimer's disease. Copyright (C) 2000 John Wiley & Sons, Ltd.