Thursday, 21 August 2003
This presentation is part of : Thursday Poster Sessions

PD-042 Rivastigmine in Schizophrenia: Effects on Quality of Life

Alessandro Lenzi, Elisabetta Maltinti, Enzo Poggi, Lazzerini Fabrizio, and Elisabetta Coli. Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, Clinica Psichiatrica, Pisa, Italy

Objective: We aimed to determine whether rivastigmine, an inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), would improve quality of life, cognition and behavioral problems in schizophrenic patients.

Design: This was an open, 12-month study. Subjects were men and women aged 18–50 years, diagnosed with the residual type of schizophrenia.

Materials and Methods: Subjects began rivastigmine treatment at a dose of 1.5 mg bid. This dose was escalated at monthly intervals in increments of 1.5 mg bid to a maximum of 6 mg bid. All patients were followed for 12 months, with periodical examinations. Quality of life was assessed through the Satisfaction with Life Domains Scale (SLDS, a self-report scale containing 18 'satisfaction' items). In addition, the Mini Mental State Examination (MMSE) was used to assess cognitive function, the Continuous Performance Test (CPT) evaluated sustained attentional function, and the Wechsler Memory Scale (WMS) evaluated different aspects of learning and memory. Tolerability assessment was based on spontaneous reports of adverse events by patients. Statistical analyses were based on patients completing the 12-month study.

Results: 16 patients were included in the study. Baseline MMSE (mean 26.6) and BPRS item scores (means ranging from 1.5 to 1.7) indicated that they were not very cognitively impaired, and that behavioural and psychotic disturbances were reasonably well controlled at study entry. Rivastigmine treatment resulted in significant improvements in quality of life, as assessed using the SLDS, particularly in terms of social and sexual behaviour at baseline to 84.0 points at 12 months. These improvements in quality of life were paralleled by significant improvements on the MMSE (p=0.002) and WMS (p<0.001), as well as trends for improvement on the CPT. Since all subjects were already receiving treatments to control their psychotic symptoms, such further improvements, especially on the BPRS, could not be anticipated. There were no reports of nausea or vomiting.

Conclusion: Rivastigmine significantly improved quality of life in patients with schizophrenia. These benefits may relate to the drug’s effects on cognitive and behavioral symptoms associated with the condition.

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