J Neuropsychiatry Clin Neurosci 1996; 8:67-73
Copyright © 1996 by American Neuropsychiatric Association
Guidelines for the use of tacrine in Alzheimer's disease: clinical application and effectiveness. Johns Hopkins Dementia Research Clinic
CG Lyketsos, K Corazzini, CD Steele and MF Kraus
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University and Hospital, Baltimore, Maryland 21287, USA.
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.
