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Comparative effects of pharmacotherapy on the maintenance of cognitive function

Published online by Cambridge University Press:  16 April 2020

H. Allain ,
S. Schück ,
N. Mauduit  and
M. Djemai
H. Allain*
Affiliation:
Department of Pharmacology, Faculté de Médecine, Université de Rennes I, 2, avenue du Professeur Léon Bernard, 35043Rennes cedex, France
S. Schück
Affiliation:
Department of Pharmacology, Faculté de Médecine, Université de Rennes I, 2, avenue du Professeur Léon Bernard, 35043Rennes cedex, France
N. Mauduit
Affiliation:
Department of Pharmacology, Faculté de Médecine, Université de Rennes I, 2, avenue du Professeur Léon Bernard, 35043Rennes cedex, France
M. Djemai
Affiliation:
Department of Pharmacology, Faculté de Médecine, Université de Rennes I, 2, avenue du Professeur Léon Bernard, 35043Rennes cedex, France
*
*Correspondence and reprints. E-mail address: Herve.Allain@univ-rennes1.fr (H. Allain).
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Summary

The quality of human cognitive performance appears today as one of the main components of quality of life, whatever the age. Ageing by itself and most of the diseases affecting the central nervous system alter higher brain functions such as memory, vigilance and attention. Dementia is the most acute example, with a cascade of behavioral and psychological consequences (BPSD), which are the main cause of the caregiver’s burden and need specific pharmacotherapy. In this respect, the problem will be the choice of the best drug in situations such as wandering, agitation, violence, and screaming. The psychotropics, however, should not deteriorate the already disturbed cognition of the patients. This is the reason why we propose to establish for each drug, and notably for the antipsychotics, a precise and exact ‘cognitive mapping’; in other words, to measure the effects of drugs on the different components of cognition. The results of such studies will be predictive of the future phase III clinical trials and therapeutic responses. As an illustration of this approach we shall relate two studies, TIATEM (phase I) and TIAGE (phase III/IV), leading to the determination of a good cognitive safety profile of an atypical neuroleptic drug, tiapride.

Keywords

antipsychoticsclinical trialscognitiondementiamemorypharmacovigilance
Type
Original article
Information
European Psychiatry , Volume 16 , Issue S1 , 2001 , pp. 35s - 41S
Copyright
Copyright © 2001 Éditions scientifiques et médicales Elsevier SAS. All rights reserved

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References

Absher, JR, Cummings, JL.Cognitive and non-cognitive aspects of dementia syndromes: an overview. Burns, X, Levy, R, Eds.; Dementia. London: Chapman and Hall; 1994. 59–76.CrossRefGoogle ScholarPubMed
Alexopoulos, GS, Silver, JM, Kahn, DA, Frances, A, Carpentier, D.Treatment of agitation in older persons with dementia. Postgraduate medicine special report. New York: McGraw-Hill; 1998.Google Scholar
Allain, H, Bentué-Ferrer, D, Belliard, S, Derouesné, C.Pharmacology of Alzheimer’s disease. Prog Med Chem 1997; 34: 1–67.CrossRefGoogle Scholar
Allain, H, Bentué-Ferrer, D, Zekri, O, Schück, S, Le Breton, S, Reymann, JM.Experimental and clinical methods in the development of anti-Alzheimer drugs. Fund Clin Pharmacol 1998; 12: 13–29.CrossRefGoogle ScholarPubMed
Allain, H, Bourin, M, Reymann, JM, Bentué-Ferrer, D, Patat, A, Schück, S. et al. Emotion, anxiolysis and memory. Hum Psychopharmacol Clin Exp 1999; 14: 80–6.3.0.CO;2-2>CrossRefGoogle Scholar
Allain, H, Dautzenberg, PHJ, Maurer, K, Schück, S, Bonhomme, D, Gerard, D.Double-blind study of tiapride versus haloperidol and placebo in agitation and aggressiveness in elderly patients with cognitive impairment. Psychopharmacology 2000; 148: 361–6.CrossRefGoogle ScholarPubMed
Allain, H, Delahaye, C, Lecoz, F, Guilleminault, C, Blin, P, Decombe, R. et al. Post-marketing surveillance of zopiclone in insomnia. Sleep 1991; 14: 408–13.CrossRefGoogle Scholar
Allain, H, Monti, J.General safety profile of zolpidem: safety in elderly, overdose and rebound effects. Eur Psychiatry 1997; 12 Suppl 1: 21s–29s.CrossRefGoogle ScholarPubMed
Allain, H, Patat, A, Lieury, A, Lecoz, F, Janus, C, Menard, G. et al. Comparative study of the effects of zopiclone (7.5 mg), zolpidem, flunitrazepam and a placebo on nocturnal cognitive performance in healthy subjects in relation to pharmacokinetics. Eur Psychiatry 1995; 10 Suppl 3: 129s–135s.CrossRefGoogle Scholar
Allain, H, Polard, E, Schück, S.Psychotropes chez le sujet âgé. Léger, JM, Clément, JP, Wertheimer, J, Eds.; Psychiatrie du sujet âgé. Paris: Médecine-Science-Flammarion; 1999. 355–64.Google Scholar
Allain, H, Raoul, P, Lieury, A, Lecoz, F, Gandon, JM.Effect of two doses of Ginkgo biloba extract (Egb 761) on the dual coding test in elderly subjects. Clin Ther 1993; 15: 549–57.Google ScholarPubMed
Allain, H, Schück, S, Bentué-Ferrer, D, Bourin, M, Vercelleto, M, Reymann, JM. et al. Anxiolytics in the treatment of BPSD. Int J Psychogeriatr 2000; 12 Suppl 1: 281–9.CrossRefGoogle Scholar
Allain, H, Schück, S.Essai clinique en gériatrie. Léger, JM, Clément, JP, Wertheimer, J, Eds.; Psychiatrie du sujet âgé. Paris: Médecine-Science-Flammarion; 1999. 561–9.Google Scholar
Amery, WK.Why there is a need for pharmacovigilance. Pharmacoepidemiol Drug Saf 1999; 8: 61–4.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Ballard, CG, O’Brien, J, Lowery, K, Are, GA, Harrison, R, Perry, R. et al. A prospective study of dementia with Lewy bodies. Age Ageing 1998; 27: 631–6.CrossRefGoogle ScholarPubMed
Ballard, CG, Saad, K, Patel, A, Gahir, M, Solis, M, Coope, B. et al. The prevalence and phenomenology of psychotic symptoms in dementia sufferers. Int J Geriatr Psychiatry 1995; 10: 477–85.CrossRefGoogle Scholar
Bocca, ML, Le Doze, F, Etard, O, Pottier, M, L’Hoste, J, Denise, P.Residual effects of zolpidem 10 mg and zopiclone 7.5 mg versus flunitrazepam 1 mg and placebo on driving performances and ocular saccades. Psychopharmacology 1999; 143: 373–9.CrossRefGoogle Scholar
Brannström, B.Care of the delirious patient. Dement Geriatr Cogn Disord 1999; 10: 416–9.CrossRefGoogle ScholarPubMed
Brayne, C, Gill, C, Huppert, FA, Barkley, C, Gehlhaar, E, Girling, DM. et al. Vascular risks and cognition dementia: results from a cohort study of the very old. Dement Geriatr Cogn Disord 1998; 9: 175–80.CrossRefGoogle Scholar
Caine, ED.Behavioural disturbances of dementia in our current nomenclature system diagnostic classification of neuropsychiatric signs and symptoms in patients with dementia. Int Psychogeriatr 1996; 8 Suppl 3: 273–9.CrossRefGoogle Scholar
Christensen, DB, Benfield, WR.Alprazolam as an alternative to low-dose haloperidol in older, cognitively impaired nursing facility patients. J Am Geriatr Soc 1998; 46: 620–5.CrossRefGoogle ScholarPubMed
Curran, HV, Pooviboonsuk, P, Dalton, JA, Ladder, MH.Differentiating the effects of centrally acting drugs on arousal and memory: an event-related potential study of scopolamine, lorazepam and diphenydramine. Psychopharmacology 1998; 135: 27–36.CrossRefGoogle Scholar
Davis, RL, Shrimpton, AE, Molohan, PD, Bradshaw, C, Feiglin, D, Collins, GH. et al. Familial dementia caused by polymerisation of mutant neuroserpin. Nature 1999; 401: 376–8.CrossRefGoogle ScholarPubMed
Delagrange, P, Guardiola-Lemaitre, B.Melatonin, its receptor and relationships with biological rhythm disorders. Clin Neuropharmacol 1997; 20: 482–510.CrossRefGoogle Scholar
Djemai-Zoghlache, M, Burger, K, Schück, S, Moller, HJ, Rapoport, SI. et al. Thérapie multiconceptuelle dans la maladie d’Alzheimer. Presse Méd 2000; 29: 1197–201.Google Scholar
Donaldson, C, Tarrier, N, Burns, A.The impact of the symptoms of dementia on caregivers. Br J Psychiatry 1997; 170: 62–8.CrossRefGoogle ScholarPubMed
Emilien, G, Maloteaux, JM, Geurts, M, Owen, MJ.Dopamine receptors and schizophrenia: contribution of molecular genetics and clinical neuropsychology. Int J Neuropsychopharmacol 1999; 2: 197–227.CrossRefGoogle ScholarPubMed
Estadieu, MC, Machou, C, Berthezene, P, Pastor, MJ, Angelini, B, Bohor, M.Bilan tolérance-efficacité d’un an d’utilisation de la tacrine dans 100 cas de maladie d’Alzheimer. Thérapie 1998; 53: 67–76.Google Scholar
Forette, F, Seux, ML, Siaessen, JA, Lutgarde, T, Birkenhägen, H, Barbarskiene, MR.Prevention of dementia in randomized double-blind placebo controlled systolic hypertension in Europe (Syst-Eur) trial. Lancet 1998; 352: 1347–51.CrossRefGoogle ScholarPubMed
Gilley, DW, Whalen, ME, Wilson, RS, Bennett, DA.Hallucinations and associated factors in Alzheimer’s disease. J Neuropsychiatry 1991; 3: 371–6.Google ScholarPubMed
Gottfries, CG.Neurochemistry and neurotransmitters. Int Psychogeriatr 1996; 8 Suppl 3: 225–31.CrossRefGoogle ScholarPubMed
Gunasekara, NS, Spenser, CM.Quetiapine. A review of its use in schizophrenia. CNS Drugs 1998; 9: 325–40.CrossRefGoogle Scholar
Heininger, K.A unifying hypothesis of Alzheimer’s disease. I Ageing sets the stage. Hum Psychopharmacol Clin Exp 1999; 14: 363–414.3.0.CO;2-R>CrossRefGoogle Scholar
Hindmarch, I.Cognition and anxiety: the cognitive effects of anti-anxiety medication. Acta Psychiatr Scand 1998; 98 Suppl 393: 89–94.CrossRefGoogle Scholar
Hirono, N, Mori, E, Ishii, K, Kitagaki, H, Sasaki, M, Ikejiri, Y. et al. Alteration of regional cerebral glucose utilisation with delusions in Alzheimer’s disease. J Neuropsychiatry 1998; 10: 433–9.CrossRefGoogle Scholar
Hirsch, C, Bartenstein, P, Minoshima, S, Mösch, D, Willoch, F, Buch, K. et al. Regional cerebral blood flow and cognitive impairment in patients with Alzheimer’s disease-evaluation of an observer-independant analytic approach. Dement Geriatr Cogn Disord 1997; 8: 98–104.CrossRefGoogle ScholarPubMed
Holden, RJ.Could a high cholesterol diet cause Alzheimer’s disease in Western Society (hypothesis). Hum Psychopharmacol Clin Exp 1999; 14: 185–8.3.0.CO;2-P>CrossRefGoogle Scholar
Karlsson, I.Drugs that induce delirium. Dement Geriatr Cogn Disord 1999; 10: 412–5.CrossRefGoogle ScholarPubMed
Katz, IR, Jestd, DV, Mintzer, JE, Clyde, C, Napolitano, J, Brecher, M. for the Risperidone Study group Comparison of risperidone and placebo for psychosis and behavioural disturbances associated with dementia: a randomized double-blind trial. J Clin Psychiatry 1999; 60: 107–15.CrossRefGoogle Scholar
Kertesz, A, Davidson, W, Fox, H.Frontal behavioural inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997; 24: 29–36.CrossRefGoogle ScholarPubMed
Kertesz, A, Munoz, D.Pick’s disease fronto-temporal dementia, and Pick complex. Emerging concepts. Arch Neurol 1998; 55: 302–4.CrossRefGoogle Scholar
Lebars, P, Katz, M, Berman, N, Itil, TM, Freedman, AM, Schatzberg, AF.A placebo-controlled, double-blind randomized trial of an extract of Ginkgo-biloba for dementia. JAMA 1997; 278: 1327–32.Google Scholar
Lieury, A, Pham, M, Jamey, M, Schuck, S, Djemai, M, Allain, H.Etude des corrélations entre autoestimation de la mémoire, test de la mémoire de vie quotidienne et carnet de vie. Thérapie 2000Google Scholar
Loo, H, Poirrier-Littre, MF, Theron, M, Rein, W, Fleurot, O.Amisulpride versus placebo in the medium term treatment of the negative symptoms of schizophrenia. Br J Psychiatry 1997; 170: 18–22.CrossRefGoogle ScholarPubMed
Madhusoodanan, S, Brecher, M, Brenner, R, Kasckow, J, Kunick, M, Negron, AE. et al. Risperidone in the treatment of elderly patients with psychotic disorders. Am J Geriatr Psychiatry 1999; 7: 132–8.CrossRefGoogle ScholarPubMed
Madhusoodanan, S, Brecher, M, Cohen, CI.Role of atypical antipsychotics in the treatment of psychosis and agitation associated with dementia. CNS Drugs 1999; 12: 135–50.CrossRefGoogle Scholar
Maixner, SM, Mellow, AM, Tandon, R.The efficacy, safety and tolerability of antipsychotics in the elderly. J Clin Psychiatry 1999; 30 Suppl 8: 29–41.Google Scholar
Malenka, RC, Nicoll, RA.Long-term potentiation–a decade of progress?. Science 1999; 285: 1870–4.CrossRefGoogle ScholarPubMed
Mann, JJ, Oquendo, OM, Underwood, MD, Arango, V.The neurobiology of suicide risk: a review for the clinician. J Clin Psychiatry 1999; 60 Suppl 2: 7–11.Google ScholarPubMed
Mintzer, JE, Hoenig, KS, Mirski, DF.Treatment of agitation in patients with dementia. Clin Geriatr M 1998; 14: 147–75.CrossRefGoogle ScholarPubMed
Mons, N, Guillou, JL, Jaffard, R.The role of Ca2+/calmoduline-stimulable adenyl cyclases as molecular coincidence detectors in memory formation. Cell Mol Life Sci 1999; 55: 525–33.CrossRefGoogle Scholar
Montastruc, JL, Bagheri, H, Lapeyre-Mestre, M, Senard, JM.Pharmacovigilance et pharmacoépidémiologie: principes, définition, méthodes et actualités en neurologie. Rev Neurol 1999; 155: 312–24.Google Scholar
Palmer, DD, Henter, ID, Wyatt, RJ.Do antipsychotic medications decrease the risk of suicide in patients with schizophrenia. J Clin Psychiatry 1999; 60 Suppl 2: 100–3.Google ScholarPubMed
Patat, A, Albertini, H, Bonhomme, D, Soubrane, C, Allain, H, Gandon, JM.Effects of tiapride on electroencephalograms and cognitive functions in the elderly. Int J Clin Psychopharmacol 1999; 14: 199–208.CrossRefGoogle ScholarPubMed
Patat, A, Rosenzweig, P, Miget, N, Allain, H, Gandon, JM.Effects of 50 mg amisulpride on EEG, psychomotor and cognitive functions in healthy sleep deprived subjects. Fund Clin Pharmacol 1996; 13: 582–94.CrossRefGoogle Scholar
Patterson, CJ.S, Gauthier, S, Bergman, H, Cohen, CA, Feightner, JW, Feldman, H. et al. The recognition, assessment and management of dementing disorders: conclusions from the Canadian consensus conference on dementia. Can Med Assoc J 1999; 160 Suppl 12: S1–S15.Google ScholarPubMed
Rao, V, Lyketsos, CG.Delusions in Alzheimer’s disease: a review. J Neuropsychiatry 1998; 10: 373–82.CrossRefGoogle ScholarPubMed
Reisberg, B, Auer, SR, Monteiro, IM.Behavioural pathology in Alzheimer’s disease (Behave-AD) rating scale. Int Psychogeriatr 1996; 8 Suppl 3: 301–8.CrossRefGoogle ScholarPubMed
Reisberg, B, Kenowsky, S, Franssen, EH, Auer, SR, Souren, LEM.Towards a science of Alzheimer’s disease management: a model based upon current knowledge of retrogenesis. Int Psychogeriatr 1999; 11: 7–23.CrossRefGoogle Scholar
Roman, GC, Tatemichi, TK, Erkinjuntti, T, Cimmings, JL, Masden, JC, Garcia, JM. et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-ARIEN International Workshop. Neurology 1993; 43: 250–60.CrossRefGoogle Scholar
Sano, M, Growdon, J, Thomas, R. et al. Evaluation of efficacy measures in clinical trials for Alzheimer’s disease: does psychometric test performance predicts clinically relevant outcomes [abstract]. Neurology 1996; 46 Suppl 2: A218.Google Scholar
Sano, M, Rosen, W, Stern, Y, Rosen, J, Mayeux, R.Simple reaction time as a measure of global attention in Alzheimer’s disease. J Inter Neuropsychol Soc 1995; 1: 56–61.CrossRefGoogle ScholarPubMed
Schmidt, I, Claesson, CB, Westerhol, M, Nilsson, LG, Svarstad, BL.The impact of regular multidisciplinary team interventions on psychotropic prescribing in Swedish nursing homes. J Am Geriatr Soc 1998; 46: 77–82.CrossRefGoogle ScholarPubMed
Schneider, LS.Pharmacologic management of psychosis in dementia. J Clin Psychiatry 1999; 60 Suppl 8: 54–60.Google ScholarPubMed
Schück, S, Bentué-Ferrer, D, Beaufils, C, Polard, E, Belliard, S, Allain, H.Effets indésirables et médicaments de la maladie d’Alzheimer. Thérapie 1999; 54: 237–42.Google Scholar
Starkstein, SE, Sabe, L, Vazquez, S, Teson, A, Petracca, G, Chemerinski, X. et al. Neuropsychological psychiatric and cerebral blood flow findings in vascular dementia and Alzheimer’s disease. Stroke 1996; 27: 408–14.CrossRefGoogle ScholarPubMed
Sultzer, DL, Levin, HS, Mahler, ME, High, WM, Cummings, JL.A comparison of psychiatric symptoms in vascular dementia and Alzheimer’s disease. Am J Psychiatry 1993; 150: 1806–12.Google ScholarPubMed
Tang, YP, Shimizu, E, Dube, GR, Rampon, C, Kerchner, GA, Zhuo, M. et al. Genetic enhancement of learning and memory in mice. Nature 1999; 401: 63–9.CrossRefGoogle ScholarPubMed
Tariot, PN.Treatment of agitation in dementia. J Clin Psychiatry 1999; 60 Suppl 8: 11–20.Google ScholarPubMed
Teng, E, Squire, LR.Memory for places learned long ago is intact after hippocampal damage. Nature 1999; 400: 675–6.CrossRefGoogle ScholarPubMed
The French Clozapine Parkinson Study Group. Clozapine in drug-induced psychosis in Parkinson’s disease. Lancet 1999; 353: 2041–2.CrossRefGoogle Scholar
Tune, LE, Egeli, S.Acetylcholine and delirium. Dement Geriatr Cogn Disord 1999; 10: 342–4.CrossRefGoogle ScholarPubMed
Volkow, N, Gur, RC, Wang, GJ, Fowler, JS, Moerg, PJ, Ding, YS. et al. Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals. Am J Psychiatry 1998; 155: 344–9.Google ScholarPubMed
Wallin, A.The overlap between Alzheimer’s disease and vascular dementia: the role of white matter changes. Dement Geriatr Cogn Disord 1998; 9 Suppl 1: 30–5.CrossRefGoogle ScholarPubMed
Zaudig, M.Assessing behavioural symptoms of dementia of the Alzheimer type: categorical and quantitative approaches. Int Psychogeriatr 1996; 8 Suppl 2: 183–200.CrossRefGoogle ScholarPubMed
Zaudig, M.Behavioural disturbances of dementia in DSMIV and ICD-10: fact or fiction. Int Psychogeriatr 1996; 8 Suppl 3: 285–288.CrossRefGoogle ScholarPubMed
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