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May 14, 2003

Cholinesterase Inhibitors for Alzheimer Disease—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(18):2359. doi:10.1001/jama.289.18.2359-a

To the Editor: In their meta-analysis, Dr Trinh and colleagues1 found that cholinesterase inhibitors (ChIs) had beneficial effects on neuropsychiatric symptoms in patients with Alzheimer disease (AD). The overall effect size was small but statistically significant and consistent across studies. This conclusion, however, may have limited value for predicting treatment effects for individual patients in clinical practice. Several lines of evidence suggest that AD is a heterogenous disease2 and that the relative efficacy of ChIs varies widely among patients.3 Moreover, this class of drugs may be also effective for patients with other neuropsychiatric syndromes.4

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