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Rivastigmine is an approved cholinesterase inhibitor with proven efficacy on cognitive and functional deficits in mild to moderately severe AD.1 The possibility that estrogen might enhance effects of cholinergic therapy was previously suggested from post hoc analyses of a 30-week, multicenter trial of tacrine,2 but no results from randomized, placebo-controlled studies are available so far.6
We studied 117 menopausal women with AD (Diagnostic and Statistical Manual, 4th ed. and National Institute of Neurological and Communicative Diseases and Stroke–AD and Related Disorders Association criteria) and a Mini-Mental State Examination (MMSE) score between 10 and 26 (both inclusive). Patients should not have received hormone replacement therapy (HRT) for the previous 10 years and previous antidementia treatment had been interrupted for at least 3 months.
Seventeen centers from France participated in this 28-week, double-blind, placebo-controlled study after approval by the ethics committee (Cochin Hospital, Paris).
All patients received rivastigmine (Exelon et Estraderm, Novartis Pharma AG, Stein, Switzerland); after an initial dosage of 1.5 mg twice …
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