Abstract
Alzheimer’s disease is a global challenge and its prevalence is steadily increasing. Increased mortality risk, shortening of survival time, and high cost of management make this disease a burden to the society. Medical treatments have a beneficial effect on patients. However, long-term use could increase risks and deprescribing might be an option during management. Donepezil, rivastigmine, and galantamine are routinely used in the management of dementia and cognitive disorders. These are included into the group of cholinesterase inhibitors, which are frequently prescribed for mild and moderate Alzheimer’s disease, but they are not indicated in very mild Alzheimer’s disease. Memantine belongs to the NMDA (N-methyl D-aspartate) receptor modulators, which show small effects in moderate-severe Alzheimer’s disease. Little effect could be shown in vascular dementia. Sudden withdrawal of acetylcholinesterase inhibitors may cause decline in cognition and increase in behavioral symptoms. Patients with Alzheimer’s disease seem to tolerate discontinuation better, compared to Lewy body and Parkinson’s disease dementia patients. Memantine is generally well-tolerated. Galantamine increases cognition in mild-moderate Alzheimer’s disease. Risk for withdrawal is increased due to adverse events in mild to moderate Alzheimer’s disease. The withdrawal of drugs at terminal state is another subject in dementia. Withdrawal can cause reactions ending in complex symptoms. Data is missing on long-term effects of these drugs. Harms of withdrawal might affect cognition and/or behavior, and adverse drug effects might develop due to withdrawal. This chapter deals with the course and duration of anti-dementia medications with a special emphasize on withdrawal syndromes.
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Yaman, A., Yaman, H. (2022). Anti-dementia Medications: Course and Duration of Therapy and Withdrawal Syndromes. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_194
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