Cholinesterase inhibitors for co-morbid Alzhemer’s disease dementia and schizophrenia: Systematic review and meta-analysis


Cholinergic dysfunction is common to Alzheimer’s dementia and Schizophrenia. The objective of this study is to undertake a systematic review and meta-analysis of the literature on the cognitive and clinical effects of cholinesterase inhibitors administered to patients with schizophrenia and co-morbid Alzheimer’s disease dementia. A literature search of the MEDLINE, CINAHL, PubMed, PsycINFO, EMBASE, AMED, BNI, HMIC and Health Business Elite databases has been performed (up to January 2013) to investigate the use of cholinesterase inhibitors in patients with schizophrenia and dementia. The terms “schizophrenia”, “dementia”, “rivastigmine”, “donepezil”, “galantamine” and “cognitive deficit” have been searched, with a restriction for English language. Five published studies including 1 RCT have been included for the qualitative review. Treatments include Donepezil 5 mg and 10 mg as well as Rivastigmine 9 mg. The numbers of participants vary from 2 incase report to20 inthe RCT. Only 1 study qualifies for meta-analysis. There is a very limited evidence on the efficacy and safety of using acetylcholinesterase inhibitors in the management of dementia co-morbid with schizophrenia. The only randomised controlled study shows lack of evidence in terms of efficacy in using cholinesterase inhibitors in the management of dementia with schizophrenia. Future research projects will have to look at an adequate sample size to explore treatment on various cognitive and noncognitive domains and the sample should be selected by using definitive and internationally acceptable diagnostic criteria.

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Badrakalimuthu, V. (2013) Cholinesterase inhibitors for co-morbid Alzhemer’s disease dementia and schizophrenia: Systematic review and meta-analysis. World Journal of Neuroscience, 3, 57-60. doi: 10.4236/wjns.2013.32008.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Arnold, S., Gur, R., Shapiro, R., et al., (1995) Prospective clinicopathologic studies of schizophrenia: Accrual and assessment of patients. American Journal of Psychiatry, 152, 731-737.
[2] Raina, P., Santaguida, P., Ismaila, A., et al. (2008) Effectiveness of cholinesterase inhibitors and memantine for treating dementia: Evidence review for a clinical practice guideline. Annals of Internal Medicine, 148, 379-397. doi:10.7326/0003-4819-148-5-200803040-00009
[3] Aleman, A., Hijiman, R., De Haa, E.H.F., et al. (1999) Memory impairment in schizophrenia: A meta-analysis. American Journal of Psychiatry, 156, 1358-1366.
[4] Heinrichs, R.W. and Zakzanis, K.K. (1998) Neurocognitive deficits in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12, 426-445. doi:10.1037/0894-4105.12.3.426
[5] Bokat, C.E. and Goldberg, T.E. (2003) Letter and category fluency in schizophrenic patients: A meta-analysis. Schizophrenia Research, 64, 73-78. doi:10.1016/S0920-9964(02)00282-7
[6] Lenzi, A. and Tuscano, D. (2004) Do acetylcholinesterase inhibitors have a role in improving cognitive impairment in patients with schizophrenia. International Journal of Pharmacological Medicine, 18, 139-148. doi:10.2165/00124363-200418030-00002
[7] Ribeiz, S., Bassitt, D., Arrais, J., et al. (2010) Cholinesterase inhibitors as adjunctive therapy in patients with schizophrenia and schizoaffective disorder: A systematic review and meta-analysis of the literature. CNS Drugs, 24, 303-317. doi:10.2165/11530260-000000000-00000
[8] Djordjevic, S., Japalak, S. and Vodojevic, V. (2010) Effect of rivastigmine tartarat in therapy of patients with schizophrenia. Annals of General Psychiatry, 9, S91.
[9] Stryjer, R., Bar, F., Strous, R., et al. (2002) Donepezil management of schizophrenia associated with dementia. Journal of Clinical Psychopharmacology, 22, 226-229. doi:10.1097/00004714-200204000-00021
[10] D. Mazeh, H. Zemishlani, Y. Braka, et al. (2006) Donepezil for the negative signs in elderly patients with schizophrenia: An add-on, double blind, crossover, placebo-controlled study. International Journal of Psychogeriatrics, 18, 429-436. doi:10.1017/S1041610205003017
[11] Stryjer, R., Strous, R., Bar, F., et al. (2003) Beneficial effects of donepezil augmentation for the management of comorbid schizophrenia and dementia. Clinical Neuropharmacology, 26, 12-17. doi:10.1097/00002826-200301000-00004
[12] Mendelsohn, E., Rosenthal, M., Bohiri, Y., et al. (2004) Rivastigmine augmentation in the management of chronic schizophrenia with comorbid dementia: An open-label study investigating effects on cognition, behaviour and activities of daily living. International Journal of Clinical Pharmacology, 19, 319-324.

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