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Table 6.25 The Effect of Rivastigmine on Learning and Memory Post ABI

 
Author/Year/ Country/Study design/PEDro Score Methods Outcome
Silver et al. (2006) USA RCT PEDro=9 N=123 Population: TBI. Rivastigmine (n=80): Mean Age=37 yr; Gender: Male=53, Female=27. Placebo (n=77): Mean Age=37.1 yr; Gender: Male=53, Female=24. Intervention: Participants were randomized to receive either rivastigmine (3-6 mg/d) or placebo. At the end of the first 4 wk, rivastigmine doses were increased to 3.0 mg, 2x/d. If necessary doses were decreased to 1.5 mg or 4.5 mg 2x/d. Outcome Measure: Trails A and B, Hopkins verbal learning test (HVLT), Cambridge Neuropsychological Test Automated Batter Rapid Visual Information Processing (CANTAB RVIP A).
  1. Results of the CANTAB RVIP A’ and HVLT found no significant differences between the placebo group and the treatment group.
  2. Rivastigmine was found to be well tolerated and safe.
Silver et al. (2009) USA Pre-Post N=127 Population: TBI. Ex-Rivastigmine (n=65): Mean Age=36.9 yr; Gender: Male=43, Female=22; Time Post Injury=73.5 mo. Ex-placebo (n=62): Mean Age=38 yr; Gender: Male=42, Female=20; Time Post Injury=100.1 mo. Intervention: Participants were randomized to receive rivastigmine injections (1.5 mg 2x/d to a max of 12 mg/d) or placebo injection. Outcome Measure:  Trails A and B, Hopkins verbal learning test (HVLT),Cambridge Neuropsychological Test Automated Batter Rapid Visual Information Processing (CANTAB RVIP A).
  1. The mean final dose of rivastigmine was 7.9 mg/day.
  2. 40% of patients were responders on CANTAB RVIP A’ or HVLT score at week 38.
  3. At the end of the study period all (n=98) were seen to improve of the CANTAB RVIP A’ (p<0.001), the HVLT (P<0.001), and the Trails A and B (p<0.001).