engleski

Donepezil combined with cobalamin substitution in the treatment of patients with mild Alzheimer's disease and subnormal serum cobalamin levels: five case reports

Aim: To present five case reports of patients with mild Alzheimer's disease (AD) and subnormal serum cobalamin levels, successfully treated with combination of donepezil and cobalamin substitution. Methods: Five patients with mild [baseline Mini-Mental State Examination (MMSE) score 21-26] probable/ possible AD, according to National Institute of Neurological and Communicative Dosorders and Stroke and the Alzhemers Disease and Related Disorders Association (NINCDS/ADRDA) criteria and subnormal serum cobalamin levels were treated with 10 mg donepezil/day orally and received cobalamin substitution parenterally. After one year follow-up period, changes in MMSE and Clinical Global Impression- Improvement (CGI-I) Score were used to objectivize changes in patient psychic status and functioning. Results: Ali five patients completed follow-up. Donepezil was generally well tolerated and only one patient ftported one side-effect: mild nausea of five days duration (first five days after donepezilprescription) that spontaneously recovered. CGI-I suggested „minimal improvements" regarding cognition and patient functioning in four of five treated patients while in one patient there were „no changes" at the end of one year follow-up. Conclusion: Donepezil in combination with parenteral cobalamin substitution therapy may be beneficial for patients with mild AD and subnormal serum cobalamin levels. Structured studies on large sample populations and of various design are needed to clarify clinical significance of our preliminary positive findings.

Mild Alzheimer's disease; AD; serum cobalamin levels; donepezil

Indexed / Abstracted in: SCOPUS