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This 12‐week, multinational study compared the tolerability and cognitive effects of donepezil (up to 10 mg once daily) and rivastigmine (up to 6 mg twice daily) in 111 patients with mild to moderate Alzheimer's disease. Both medications were administered open label according to recommended dosing regimens from the respective product labelling available during the conduct of the study. More patients in the donepezil group (89.3%) completed the study compared with the rivastigmine group (69.1%; p=0.009), and 10.7% of the donepezil group and 21.8% of the rivastigmine group discontinued due to adverse events (AEs); 87.5% of donepezil‐treated patients and 47.3% of rivastigmine‐treated patients remained on the maximum approved dose of each drug at the last study visit. Both groups showed comparable improvements on the ADAS‐cog administered by raters blind to study medication at weeks 4 and 12. Thus, using the recommended dosing schedules, donepezil was better tolerated with fewer discontinuations due to AEs, and both agents improved cognition to a similar extent.

We studied the plasma chain-breaking antioxidants α and carotene, β carotene, lycopene, Vitamin A, Vitamin C, Vitamin E and a measure of total antioxidant capacity, TAC, in 79 patients with Alzheimer's disease (AD), 37 patients with vascular dementia (VaD), 18 patients with Parkinson's disease and dementia (PDem), and 58 matching controls, together with 41 patients with Parkinson's disease (PD) and 41 matching controls. Significant reductions in individual antioxidants were observed in all dementia groups. When compared to controls, the following were reduced: Vitamin A in AD (p<0.01) and VaD (p<0.001); Vitamin C in AD (p<0.001), VaD (p<0.001) and PDem (p<0.01); Vitamin E in AD (p<0.01) and VaD (p<0.001); β carotene in VaD (p=0.01); lycopene in PDem (p<0.001). Lycopene was also reduced in PDem compared to AD (p<0.001) and VaD (p<0.001). Antioxidant levels in PD were not depleted. No significant changes in TAC was seen in any group. The reduction in plasma chain-breaking antioxidants in patients with dementia may reflect an increased free-radical activity, and a common role in cognitive impairment in these conditions. Increased free-radical activity in VaD and PDem could be associated with concomitant AD pathology. Individual antioxidant changes are not reflected in TAC.

The antihypertensive efficacy and metabolic effects of cyclopenthiazide 125 μg were compared with cyclopenthiazide 500 μg in patients with non-insulin dependent diabetes and hypertension in a double blind, randomized crossover study. After a 6-week placebo period 24 patients with non-insulin dependent diabetes mellitus, stabilized on diet or oral hypoglycaemic agents, who had a mean diastolic blood pressure between 90 and 120 mmHg after receiving placebo for 6 weeks were given 125 μg or 500 μg cyclopenthiazide for 12 weeks. Patients then received placebo for a further 6-week period, following which they received the alternate treatment dosage for 12 weeks. There were no differences between doses in their antihypertensive effects. While 500 μg significantly reduced systolic and diastolic blood pressures, only diastolic pressure was significantly reduced by 125 μg from pre-treatment values. The higher dose of cyclopenthiazide had greater effects on measures of diabetic control than did the 125 μg dose and the rise in blood glucose after 12 weeks' treatment with 500 μg was significantly different from pre-treatment values. Cyclopenthiazide 125 μg had significantly less effect on triglycerides, potassium and urate, than did 500 μg. Cyclopenthiazide 500 μg resulted in a significant fall in serum potassium from pre-treatment values. There were no intertreatment differences in the other variables measured. Cyclopenthiazide 125 μg is as effective as 500 μg in reducing diastolic blood pressure in mildly hypertensive non-insulin dependent diabetic patients. The higher dose had more pronounced adverse effects on glucose control and serum concentrations of triglycerides, potassium and urate.