The efficacy of tacrine for treatment of Alzheimer's has been
demonstrated in several clinical trials but has not been assessed in cases
complicated by medical and psychiatric comorbidities. Additionally, the
benefit-risk ratio of tacrine is small, so it is best administered with
carefully developed guidelines that specify this ratio for patients and
families. On the basis of guidelines developed for the Johns Hopkins
Dementia Research Clinic, tacrine treatment was offered to 162 patients
with probable Alzheimer's. Only 35 accepted, and only 22 continued on
tacrine beyond 3 months. The latter group declined by 1.36 points over 1
year on the Mini-Mental State Examination, significantly less than
expected. The authors conclude that, if used in the context of clinical
guidelines, tacrine is an effective treatment for Alzheimer's.Abstract Teaser