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Differential Neuropsychiatric Symptom Responses to Tacrine in Alzheimer's Disease

Relationship to Dementia Severity

Received January 6, 1997; revised March 19, 1997; accepted March 27, 1997. From the Departments of Neurology and Psychiatry/Biobehavioral Sciences, University of California at Los Angeles School of Medicine; the Behavioral Neuroscience Section, Psychiatry Service, and Nursing Service, West Los Angeles Veterans Affairs Medical Center, Los Angeles, California; and the Departments of Psychiatry and Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Address correspondence to Dr. Kaufer, 4 West ADRC, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213.

Neuropsychiatric symptom responses to tacrine were investigated in an open-label study of Alzheimer's outpatients. Forty subjects were stratified into three groups (Mild, Moderate, and Severe) based on Mini-Mental State Examination scores. A significant reduction in total Neuropsychiatric Inventory score across all subjects was principally attributable to changes in the Moderate group. Apathy and disinhibition symptoms were significantly reduced overall. Whereas other symptoms showed differential responses in Mild and Severe subjects, all symptoms improved in Moderate subjects. These findings suggest that disease severity may significantly influence neuropsychiatric symptom responses to tacrine. Putative mechanisms underlying the observed pattern of responses are explored.

Key Words: Alzheimer's Disease • Tacrine • Treatment Strategies

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