2006 issue 1

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Volume 22, issue 1

Original article

Beneficial effects of valproate addition to donepezil treatment in Alzheimer’s disease

Alina Borkowska1, Marta Tomaszewska1, Monika Wilkość1, Andrzej Cichosz2, Wiktor Dróżdż1, Janusz Rybakowski3
1. Zakład Neuropsychologii Klinicznej Uniwersytetu im. Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy
2. Poradnia Neurologiczna Szpitala Uniwersyteckiego, Uniwersytet im. Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy
3. Klinika Psychiatrii Dorosłych Akademii Medycznej w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii, 2006, 1, 19–25
Keywords: Alzheimer’s disease, valproate, depression, cognitive functions, behavioral disturbances

Abstract

Aim: the aim of this paper was an assessment of the effect of addition of valproate (Depakine-chrono) (sodium valproate + valproic acid) to donepezil treatment on various aspects of mental state and cognitive functions in patients with Alzheimer’s disease.
Methods: forty-one patients with Alzheimer’s disease (24 male, 17 female), aged 50-90 (mean 71+11) years participated in the study. Patients were randomly allocated to two groups: group I – 21 patients, continuing previous treatment with donepezil, and group II – 20 patients receiving donepezil and valproate (Depakine) in dose up to 600 mg/day.
Results: before randomization, initial results of psychometric scales were not different in both groups. After three-month treatment, a significant reduction of depressive symptoms, measured with Cornell Scale for Depression in Dementia, and various behavioral disturbances, measured with Dementia Behavior Disturbance Scale (DBDS) was shown in the group treated with donepezil and valproate. Initial results of neuropsychological tests before randomization were not different in both groups except for the Clock Drawing Test, worse in donepezil and valproate group. Any significant differences between these groups were also not shown after three-month treatment. Patients treated with donepezil plus valproate who had better improvement in DBDS scale obtained also better results on Mini-Mental State Examination, Alzheimer’s Disease Assessment Scale (ADAS-cog) and the Word Fluency Test.
Conclusions: the results of this paper show that the addition of low doses of valproate to donepezil treatment may bring about significant therapeutic benefits.

Address for correspondence:
dr hab. n. med. Alina Borkowska, Zakład Neuropsychologii Klinicznej,
Uniwersytet im Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy,
ul Marii Skłodowskiej-Curie 9, 85-094 Bydgoszcz, tel. 52,5853702; fax. 52,5853703;
e-mail: alab@cm.umk.pl