Competition for clinical cases in Alzheimer’s disease (CCCAD) – Janssen-Cilag

Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive status and dementia. Treatment of MCI with cholinesterase inhibitors (ChEIs) or other medications remains a controversial issue, although many experts agree that ChEIs are effective in the treatment of MCI, especially the amnestic type. We report a case of a 74-year-old Brazilian man, with memory complaints and mild depressive symptoms, which were confirmed by family members but not severe enough to interfere with his daily life activities as a lawyer. Neuropsychological examination confirmed the memory impairment but also revealed initiation/perseveration deficit. He was treated with galantamine and sertraline (50 mg/day). When the maximum dose of galantamine (24 mg/day) was reached, improvement was observed by the patient, family members and medical staff. The patient had excellent evolution associated with this treatment and since then annually repeated neuropsychological evaluations have revealed memory impairment but no further cognitive decline over the last six years. For a short period of time, the doses of galantamine had to be reduced because the drug was not available for purchase. The patient and family members reported a clear cognitive decline during this period, which remitted when the habitual doses of 24 mg/day were reintroduced. Although it is not possible to be sure of the effect of galantamine or of the association of galantamine and sertraline on the evolution of this case, it is remarkable that his condition remained unchanged on comprehensive neuropsychological evaluations performed over a long period of time.