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Industry-sponsored studies have repeatedly found that cholinesterase inhibitors reduce agitation and improve cognition in patients with Alzheimer disease. In this British trial, 221 Alzheimer patients — with clinically significant agitation, living in the community or residential care facilities, and unresponsive to a 4-week trial of “psychosocial therapy” — completed 12 weeks of blinded, random-assignment treatment with placebo or donepezil (dose gradually raised to the usual 10 mg). Agitation and cognition were assessed regularly.
The researchers found no between-group differences in overall reduction of agitation, in the percentage of patients with a 30% or greater decrease in agitation scores, and in total psychopathology scores measured…