english.prescrire.org > Spotlight > Archives : 2007 > In the April issue of Prescrire International: Rivastigmine

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In patients with both Parkinson’s disease and dementia, a placebo-controlled trial has confirmed that the adverse effects of rivastigmine outweigh its benefits. It is better to carefully adjust ongoing antiparkinsonian treatments than to add an anticholinesterase.

In practice: focus on treating Parkinson’s disease. About 5% of patients with dementia treated with rivastigmine showed a cognitive improvement, but the treatment also caused nausea and vomiting in about 15% of patients and tremor in about 6%.

It is better to fine-tune ongoing treatment for Parkinson’s disease as the disease progresses than to add rivastigmine. After all, what is the point of exposing patients to a risk of adverse effects and drug-drug interactions when there is little if any chance of a therapeutic benefit? ©Prescrire April 2007

Source: Prescrire International 2007; 16 (88): 66.

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