Rivastigmine
- PDF / 170,651 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 19 Downloads / 140 Views
1 S
Weight loss: case report A 75-year-old woman experienced weight loss during treatment with rivastigmine for Alzheimer’s disease (AD). The woman presented to the clinic in September 2018 with a history of fatigue, feeling of hopelessness, loss of appetite and loss of interest in daily activities. She reported feeling sick and discomfort for almost 6 months. She also reported experiencing abdominal pain for 2 months and gradually lost 19kg over this period. She was initiated on rivastigmine patch for AD from November 2017 [dosage not stated]. In March 2018, rivastigmine dosage was increased to 13.3 mg/day (15cm2) [route not stated]. She went to emergency department a few times for nausea and fatigue after the increase in dosage. She was concomitantly initiated on quetiapine. Use of donepezil was reported, which caused anorexia and emesis after 1 month. On examination, her BP in standing and sitting position was 130/80 and 130/70mm Hg. Her weight was 43kg and BMI was 19.4 kg/cm2. She was emaciated and exhibited a depressive mood. Mild to moderate AD was confirmed by neuropsychological assessment and cognitive testing which included clock drawing test score of 2/6 and Mini-Mental State Examination score of 22/30. Her Mini-Nutritional Assessment-Short Form score was 4, which indicated malnutrition. Laboratory investigations revealed glomerular filtration rate of 60 mL/min. Upper endoscopy showed erythematous pangastritis. Abdominal ultrasound revealed a stone of 3cm in the gall bladder. Rivastigmine patch was discontinued and a nutrition counselling was initiated. The woman exhibited improvement in her appetite and resolution of abdominal pain within 1 week of rivastigmine discontinuation. Quetiapine was discontinued and mirtazapine was started to stimulate appetite and manage her depression. After 4 weeks, her weight was noted to be increased by 6kg. A marked improvement in cognition and mood was observed after 2 months along with an increase in weight to 51kg. It was stated that, there was no worsening of cognitive abilities and decrease in weight even after 1 year follow-up. Clinical remission of her depressive symptoms were noted. Her Mini-Nutritional Assessment-Short Form score was 12, which indicated a normal nutritional status and her weight was 53kg. The causal relationship between rivastigmine and weight loss using Naranjo Criteria scale was reported as definite (a score of 9). Naharci MI, et al. Massive Weight Loss From Rivastigmine Patch in an Older Patient: A Rare Case. Journal of Clinical Psychopharmacology : 19 Aug 2020. Available from: 803502035 URL: http://doi.org/10.1097/JCP.0000000000001254
0114-9954/20/1822-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 19 Sep 2020 No. 1822
Data Loading...
