Efficacy of acetylcholinesterase inhibitors versus nootropics in Alzheimer's disease: a retrospective, longitudinal study. 

Tsolaki M, Pantazi T, Kazis A.

Third Department of Neurology, 
Aristotle University of Thessaloniki, Greece.  
J Int Med Res
2001 Jan-Feb;29(1):28-36

Abstract

The aim of this study was to investigate the efficacy of nootropics (piracetam, aniracetam, nimodopine and dihydroergicristine) versus acetylcholinesterase inhibitors (AChE-Is) (tacrine and donepezil) in the treatment of Alzheimer's disease. This is a retrospective study of 510 patients with Alzheimer's disease. To determine clinical efficacy of treatment, we used the mean change over time in scores for the following tests: the Mini-Mental State Examination (MMSE); the Cambridge Cognitive Examination for the Elderly; and the Functional Rating Scale for Symptoms of Dementia. In all patients and in patients with severe Alzheimer's disease (baseline MMSE < 11), no significant differences were seen in the neuropsychological test scores between the two treatment groups. In patients with moderate dementia (baseline MMSE between 11 and 20), however, there was a significantly greater deterioration, as shown on the CAMCOG scale, after 12 months' treatment for patients receiving AChE-Is compared with those receiving nootropics (-4.38 for AChE-Is group versus 1.48 for nootropics group). For patients with mild dementia (baseline MMSE score between 21 and 26), there was a significantly greater deterioration on the MMSE scale for each time-point in the nootropics group compared with the AChE-Is group. In conclusion, we did not find any strong evidence that a difference in efficacy exists between AChE-Is and nootropics in the treatment of Alzheimer's disease.

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Alzheimer's disease
    piracetam  and Alzheimer's 
    piracetam  therapy in Alzheimer's
    piracetam  use in Alzheimer's
    piracetam  induced changes in Alzheimer's
    piracetam  effect on Alzheimer's
    piracetam  reverses hippocampal changes in Alzheimer's
    piracetam  and Alzheimer's disease
    piracetam  controlled study on dementia
    piracetam  effect on senile dementia memory
Alcoholism
    piracetam  in acute alcohol withdrawal
    piracetam  alcoholic treatment
    piracetam  efficacy in chronic alcoholics
    piracetam  effect on alcoholics
Child birth
    piracetam  in parturients and newborn infants
    piracetam  reduced duration of labor
    piracetam  protective effect during delivery
    piracetam  concentrations during delivery
Circulatory Disorders
    piracetam  effectiveness in cerebral arteriosclerosis
    piracetam  and chronic cerebrovascular disorders
    piracetam  effect on brain circulation failure
Dyslexia
    piracetam  learning aid in dyslexia
    piracetam  in children with dyslexia
    piracetam  in students with dyslexia
    piracetam  efficacy in dyslexic reading and writing disorders
    piracetam  verbal effect in dyslexic boys
    piracetam  improves reading in dyslexia
Head injury
    piracetam  and concussion
    piracetam  effect on consciousness due to head injury
    piracetam  protection in brain injury
    piracetam  use in severe brain injury
Hearing loss
    piracetam  use in sudden deafness
    piracetam  sudden hearing loss treatment
    piracetam  in tinnitus and sudden deafness
    piracetam  treatment of sudden deafness
Heart Disease
    piracetam  effects on arterial hypertension
    piracetam  effect on elderly coronary heart disease
    piracetam  in chronic ischemic heart disease
    piracetam  in ischemic heart disease
    piracetam  in myocardial infarct patients
Mental Performance
    piracetam  improved mental performance
    piracetam  and nootropics
    piracetam  in patients with mental decline 
    piracetam  effects on cognitive functions
    piracetam  improves memory
    piracetam  efficacy in cognitive impairment
    piracetam  memory impairment trial
    piracetam  and EEG of boys with learning disorders
    piracetam  effect on adolescent brain function
    piracetam  effects on human EEG
    piracetam  on change in brain functional state
    piracetam  effects on brain functions
    piracetam  in elderly cerebral impairment
    piracetam  in cerebral impairment
Stroke
    piracetam  in secondary stroke prophylaxis
    piracetam  improves blood flow of post-stroke patients
    piracetam  improves aphasia in acute stroke
    piracetam  in the treatment of acute stroke
    piracetam  evaluation in acute stroke
    piracetam  in stroke-unduced Aphasia
    piracetam  treatment in ischemic stroke
    piracetam  treatment of patients with an ischemic stroke
    piracetam  acute stroke study
    piracetam  effect on post-stroke recovery
    piracetam  improvement in Stroke
    piracetam  adjuvant to language therapy for aphasia
Vertigo
    piracetam  treatment for vertigo
    piracetam  is effective in vertigo
    piracetam  effect in 55 vertigo patients
    piracetam  subjective improvement in vertigo
    piracetam  significantly reduced vertigo symptoms
Myoclonus
    piracetam  and reduction of myoclonus
    piracetam  relieves symptoms in myoclonus epilepsy
    piracetam  in cortical myoclonus
    piracetam  and progressive myoclonus epilepsy
    piracetam  in patients with myoclonus
    piracetam  in progressive myoclonus epilepsy
    piracetam  promising results in myoclonus epilepsy
    piracetam  long-term efficacy in myoclonus epilepsy
    piracetam  beneficial use for severe myoclonus epilepsy
    piracetam  beneficial effect on post-ischaemic myoclonus
Raynaud's
    piracetam  treatment of Raynaud's
    piracetam  evidence for its anti-platelet effect in Raynaud's
    piracetam  platelet anti-aggregant properties
Sickle Cell disease
    piracetam  treatment of children with sickle cell disease
    piracetam  improves sickle cell deformability
    piracetam  crises management of sickle cell disease
Misc.
    piracetam  mechanism of action
    piracetam  elevates cholinergic receptor density
    piracetam  cholinergic receptor function in mice
    piracetam  effects on schizophrenia
    piracetam  effect on cerebral glucose utilization
    piracetam  improved driving in elderly motorists
    piracetam  unique mode of action
    piracetam  study age-related memory disorders
    piracetam  psychological treatment
    piracetam  and aging
    piracetam  and vigilance
    piracetam  versus acetylcholinesterase inhibitors
    piracetam  effects on arterial hypertension
    piracetam  in cerebral palsy
    piracetam  auxiliary treatment of cerebral palsy
    piracetam  interaction in the motor cortex
    piracetam  effect on consciousness after neurosurgery
    piracetam  effect on cerebral infarction
    piracetam  improves cognitive deficits in early Parkinsonism
    piracetam  therapy in recurrent duodenal ulcer
    piracetam  efficacy in recurrence of duodenal ulcer
    piracetam  efficacy in breath-holding spells
    piracetam  treatment of migraine
    piracetam  treatment of soft tissue rheumatism 
    piracetam  effect on intellectually deficient children
    piracetam  effect on neuroleptic-induced side effects
    piracetam  improved school-performance in legasthenia

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