Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study Martin R. Farlow, M.D., Leone Atkinson, M.D., Ph.D., Jennifer Steadman, M.S.W., Barbara Koumaras, B.A., Michael Chen, Ph.D., and Dario Mirski, M.D.From the Department of Neurology, Nova Southeastern University, Fort Lauderdale, Fla. (Dr. Sadowsky); Department of Neurology, Indiana University School of Medicine, Indianapolis, Ind. (Dr. Farlow); and Novartis Pharmaceuticals Corporation, East Hanover, N.J. (Drs. Atkinson, Chen, and Mirski and Mss. Steadman and Koumaras)Successful treatment with an alternative ChE inhibitor may be impacted by the way the initial switch is accomplished. The treatment objective is to avoid both rapid symptomatic worsening resulting from cessation of the first medication and adverse event emergence or reemergence secondary to initiation of the subsequent product. Several completed studies have been instrumental in providing information on effective switching strategies. Clinical trials with donepezil included a 3-or 6-week washout period and provided important data regarding loss of treatment effects associated with discontinuation of treatment. Although patients treated with donepezil demonstrated significant improvement on cognitive testing during active treatment, scores fell dramatically following the washout period.
