Pharmacopsychiatry 2020; 53(03): 109-114
DOI: 10.1055/a-1076-8228
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Efficacy and Safety of Psychostimulants for Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Taro Kishi
1   Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
,
Kenji Sakuma
1   Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
,
Nakao Iwata
1   Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
› Author Affiliations
Funding: This study was supported by an unrestricted grant from Daiichi Sankyo. Daiichi Sankyo had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors declare no conflicts of interest.
Further Information

Publication History

received 10 October 2019
revised 22 November 2019

accepted 03 December 2019

Publication Date:
30 January 2020 (online)

Abstract

Introduction Several reports of the effectiveness of the use of psychostimulants for the treatment of Alzheimer’s disease (AD) are available.

Methods A systematic review and meta-analysis was conducted including double-blind, randomized, placebo-controlled trials. Outcomes were the improvement of apathy scales score (primary), mini-mental state examination (MMSE) score, activities of daily living scale score, Zarit burden interview score, all-cause discontinuation, discontinuation due to adverse events, and incidence of at least 1 adverse event.

Results Three methylphenidate studies and 1 modafinil study were identified (n=156). Results from combined psychostimulants were superior to placebo in the improvement of apathy scales score (standardized mean differences [SMD]=−0.63 (−1.22, −0.04), p=0.04, all studies) and the MMSE score (SMD=−0.58 (−1.14, −0.02), p=0.04, 3 methylphenidate studies). The modafinil study was excluded from the meta-analysis for the improvement of apathy scales score; therefore, the effect size increased (SMD=−0.82 (−1.43, −0.20), p=0.009). However, no significant differences were observed in terms of other outcomes, including safety outcomes between the treatment groups.

Discussion Methylphenidate would be effective in treating apathy and cognitive impairment in AD patients.

Supplementary Material

 
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