What does the research say about using cholinesterase inhibitors or memantine to improve cognition or function?
This is the Medscape Psychiatry Minute. I'm Dr. Peter Yellowlees. Cognitive enhancers, including cholinesterase inhibitors and memantine, are used to treat dementia, but their effectiveness for mild cognitive impairment is unclear. Now a team of investigators from Toronto, Canada, have conducted a systematic review to examine the efficacy and safety of cognitive enhancers for mild cognitive impairment. The investigators screened 15,554 titles and abstracts and 1384 full-text articles for studies of the effects of donepezil, rivastigmine, galantamine, or memantine on mild cognitive impairment. From this extensive literature, only 8 randomized clinical trials and 3 companion reports met inclusion criteria. In these studies, the investigators found no significant effects of cognitive enhancers on cognition or function. Cognitive enhancers were associated with higher risks for nausea, diarrhea, and vomiting than placebo. Although much more research is needed into the overall value of cognitive enhancers, the findings from this study do not support their use in patients with mild cognitive impairment. This article is selected from Medscape Best Evidence. I'm Dr. Peter Yellowlees.
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