レビー小体型認知症に対してリバスチグミンからの切り替えで低用量長期間ガランタミン投与が有効だった1症例

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  • A Case of Dementia with Lewy Bodies Effectively Treated by Switching from Rivastigmine to Long-Term Low-Dose Galantamine Administration

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<p>For seventeen months, a pharmacist visited an elderly care facility with the family doctor and continuously monitored a patient who was receiving medication. In July and August 20XX, this patient was hospitalized because of asymptomatic cerebral infarction. She had been receiving treatment for Lewy body dementia at the facility. After release from hospital in September and October 20XX, she repeatedly, developed dermatitis, whenever a rivastigmine patch was used. Also, her symptoms of parkinsonism, such as muscular rigidity, was not seen to improve. Rather, her symptoms worsened. In November 20XX, when the doctor and pharmacist visited her for diagnosis, the pharmacist told the doctor that her dermatitis was severe. The patient’s prescription was changed from rivastigmine patches to galantamine (8mg/day). In January the following year, the family doctor increased the dose of galantamine to 16mg/day. After that, she was hospitalized for feeling nausea, in February of that year. The administration of galantamine was stopped and she returned to her elderly care facility in April of that year. The pharmacist in charge suggested the doctor prescribe a low dose of galantamine as some improvement in her symptoms were observed in December 20XX. The pharmacist recorded the patient’s condition on an analogue scale and made an assessment based on the NM scale and N-ADL using medication history and information from caregivers at the facility. As a result, it became clear that there is some possibility of improving Lewy body dementia by the long-term administration of low-dose galantamine without any associated side effects.</p>

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