We presented the patient with relative younger Alzheimerâs disease (AD) whose clinical symptoms and cognitive functions were responsive not to donepezil but to rivastigmine. Age of initial visit our memory clinic of this patient was relatively younger. It is considered that in relative older patient both AD pathology and aging cause cognitive dysfunctions. Accordingly the ratio of BuChE/AChE increases. Therefore, when at mild stage such our patient, not donepezil but rivastigmine which has inhibiting actions on both AChE and BuChE was suitable.In Japan, two cholinesterase inhibitors (ChEIs), galantamine and rivastigmine, are marketed in 2011 in addition to donepezil. As one ChEI is not allowed to be combined with other ChEI, we should select one of three ChEIs for the patient Alzheimerâs disease (AD). We considered that donepezil was not effective because his wife complained that his demented state was not changed. We prescribed rivastigmine in stead of donepezi.
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Last date updated on January, 2021