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Antidementia drug use among community-dwelling individuals with Alzheimer's disease in Finland: a nationwide register-based study.

https://arctichealth.org/en/permalink/ahliterature260126
Source
Int Clin Psychopharmacol. 2014 Jul;29(4):216-23
Publication Type
Article
Date
Jul-2014
Author
Heidi Taipale
Antti Tanskanen
Marjaana Koponen
Anna-Maija Tolppanen
Jari Tiihonen
Sirpa Hartikainen
Source
Int Clin Psychopharmacol. 2014 Jul;29(4):216-23
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy
Cholinesterase Inhibitors - adverse effects - therapeutic use
Cohort Studies
Diagnostic and Statistical Manual of Mental Disorders
Drug Monitoring
Drug Prescriptions
Drug Therapy, Combination - adverse effects
Excitatory Amino Acid Antagonists - adverse effects - therapeutic use
Female
Finland
Follow-Up Studies
Galantamine - adverse effects - therapeutic use
Guideline Adherence
Humans
Indans - adverse effects - therapeutic use
Male
Memantine - adverse effects - therapeutic use
Nootropic Agents - adverse effects - therapeutic use
Phenylcarbamates - adverse effects - therapeutic use
Piperidines - adverse effects - therapeutic use
Practice Guidelines as Topic
Proportional Hazards Models
Registries
Abstract
The objective of this study was to investigate the prevalence of acetylcholinesterase inhibitor (AChEI) and memantine use, duration of treatment, concomitant use of these drugs, and factors associated with the discontinuation of AChEI therapy during 2006-2009. We utilized data from a nationwide sample of community-dwelling individuals with a clinically verified Alzheimer's disease diagnosed during the year 2005 (n=6858) as a part of the MEDALZ-2005 study. During the 4-year follow-up, 84% used AChEI and 47% used memantine. Altogether, 22% of the sample used both drugs concomitantly. The median duration of the first AChEI use period was 860 (interquartile range 295-1458) days and 1103 (interquartile range 489-1487) days for the total duration of AChEI use. Although 20% of the AChEI users discontinued the use during the first year, over half of them restarted later. The risk of discontinuation was higher for rivastigmine [hazard ratio 1.34 (confidence interval 1.22-1.48)] and galantamine users [hazard ratio 1.23 (confidence interval 1.15-1.37)] compared with donepezil users in the adjusted model. In conclusion, median time for AChEI use was over 3 years and every fifth Alzheimer's disease patient used AChEI and memantine concomitantly during the follow-up. The low rate of discontinuation is consistent with the Finnish Care Guideline but in contrast to the results reported from many other countries.
Notes
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PubMed ID
24608822 View in PubMed
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Different conclusions about memantine.

https://arctichealth.org/en/permalink/ahliterature161328
Source
Can Fam Physician. 2007 Mar;53(3):403-4; author reply 404
Publication Type
Article
Date
Mar-2007
Author
Joel Lexchin
Source
Can Fam Physician. 2007 Mar;53(3):403-4; author reply 404
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis - drug therapy
Canada
Dose-Response Relationship, Drug
Drug Administration Schedule
Excitatory Amino Acid Antagonists - adverse effects - therapeutic use
Female
Humans
Male
Memantine - adverse effects - therapeutic use
Randomized Controlled Trials as Topic
Risk assessment
Sensitivity and specificity
Severity of Illness Index
Treatment Outcome
United States
Notes
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Comment On: Can Fam Physician. 2007 Jan;53(1):50-417872609
PubMed ID
17872671 View in PubMed
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