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Antipsychotic drugs are widely used to treat agitation in patients with Alzheimer disease (AD), but side effects are problematic and effectiveness is modest at best. Would cholinesterase inhibitors, which are used to improve cognition in Alzheimer dementia, be a suitable alternative for treatment of agitation and behavioral disturbances?
U.K. researchers enrolled 272 patients with AD who had clinically significant agitation (most had not responded to a brief psychosocial treatment program designed to reduce agitation with nondrug interventions). Patients were randomized to receive the cholinesterase inhibitor donepezil (Aricept) or placebo for 12 weeks. The primary outcome, scores on a standardized agitation inventory, did not differ signifi…