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Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis
Stinton C, McKeith I, Taylor JP, Lafortune L, Mioshi E, Mak E, Cambridge V, Mason J et al.. The American journal of psychiatry, 2015-06-18
Topic: Risk, prevention and care in population studies
Objective The authors examined research on effects, costs, and patient and caregiver views of pharmacological management strategies for Lewy body dementia. Method Studies were identified through bibliographic databases, trials registers, gray literature, reference lists, and experts. The authors used the search terms "Lewy or parkinson" and "dementia" through March 2015 and used the following inclusion criteria: participants with diagnoses of Lewy body dementia, dementia with Lewy bodies, or Parkinson's disease dementia (or participants' caregivers); investigation of pharmacological management strategies; outcome measures and test scores reported. Data extraction and quality assessment were conducted by at least two authors. Meta-analyses were conducted, and when studies could not be combined, summaries were provided. Results Forty-four studies examining 22 strategies were included in the review. Meta-analysis indicated beneficial effects of donepezil and rivastigmine for cognitive and psychiatric symptoms. Rivastigmine, but not donepezil, was associated with greater risk of adverse events. Meta-analysis of memantine suggested that it is well tolerated but with few benefits. Descriptive summaries provide some evidence of benefits for galantamine, modafinil, levodopa, rotigotine, clozapine, duloxetine, clonazepam, ramelteon, gabapentin, zonisamide, and yokukansan. Piracetam, amantadine, selegiline, olanzapine, quetiapine, risperidone, and citalopram do not appear to be effective. Conclusions High-level evidence related to pharmacological strategies for managing Lewy body dementia is rare. Strategies for important areas of need in Lewy body dementia, such as autonomic symptoms and caregiver burden, have not been investigated, nor have the views of patients and caregivers about pharmacological strategies.
Key findings
- Results Forty-four studies examining 22 strategies were included in the review.
- Rivastigmine, but not donepezil, was associated with greater risk of adverse events.
- Meta-analysis of memantine suggested that it is well tolerated but with few benefits.
Why it matters
This review and meta-analysis found that donepezil and rivastigmine helped cognitive and psychiatric symptoms in Lewy body dementia, that rivastigmine carried a greater risk of adverse events, and that memantine was well tolerated but with few benefits. These findings are about managing symptoms of Lewy body dementia, not about curing or preventing Alzheimer's disease.
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Study details
- Study designmeta-analysis
- Evidence strengthHigh
How this study scored 66/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of psychiatry) |
| Journal's citation record | 4 / 4 | American Journal of Psychiatry: journal h-index 549 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 264 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.3 citations a year over 13 year(s) since 2015 |
| Impact for its field and year | 3 / 6 | Cited 4.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 3 / 4 | Cited 56 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author John Tiernan O'Brien: h-index 140 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Cambridge: institution h-index 1,973 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26085043) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 66 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1176/appi.ajp.2015.14121582
- PubMed: 26085043
- Original source →
- Free full text: Apollo (University of Cambridge) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Stinton, C., McKeith, I., Taylor, J. P., Lafortune, L., Mioshi, E., Mak, E., et al. (2015). Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis. The American journal of psychiatry. https://doi.org/10.1176/appi.ajp.2015.14121582
Vancouver
Stinton C, McKeith I, Taylor JP, Lafortune L, Mioshi E, Mak E, et al. Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis. The American journal of psychiatry. 2015. doi:10.1176/appi.ajp.2015.14121582. PMID: 26085043.
BibTeX
@article{stinton2015-26085043,
author = {Stinton, C. and McKeith, I. and Taylor, J. P. and Lafortune, L. and Mioshi, E. and Mak, E. and Cambridge, V. and Mason, J. and others},
title = {{Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis}},
journal = {The American journal of psychiatry},
year = {2015},
doi = {10.1176/appi.ajp.2015.14121582},
pmid = {26085043},
url = {https://doi.org/10.1176/appi.ajp.2015.14121582}
}
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