The Effects of Donepezil, Galantamine, Rivastigmine and Memantine on Mini-Mental State Examination and Mean Flow Velocity in Patients with Vascular Dementia: A Double-Blinded Randomized Clinical Trial

Vascular dementia is one of the most common forms of dementia. At now, there is no treatment available to cure vascular dementia or to alter its clinical course. Some studies suggest that some drugs may be useful in controlling symptoms. The aim of this study was to evaluate the effects of donepezil, memantine, rivastigmine and galantamine on mean flow velocity and Mini-Mental State Examination of patients with vascular dementia in a three- month follow-up period.

This double-blind clinical trial was conducted on 44 patients with vascular dementia. Vascular dementia was diagnosed based on the DSM-V criteria. According to the order of entry into the study, the participants were treated with one of the selected drugs [donepezil (10 mg/d), memantine (10 mg/d), galantamine (8 mg/d) and rivastigmine (6 mg/d)]. The sampling finished whenever 11 patients in each group completed the three-month trial. The MMSE and color Doppler ultrasound was performed for all participants before and three months after the intervention.

According to the findings, there was no significant difference among the groups in the frequency of variables and the mean scores of Mini-Mental State Examination before the intervention, but the administration of memantine and donepezil significantly increased Mini-Mental State Examination score (P = 0.009 and P = 0.001 respectively). Moreover, rivastigmine, galantamin and donepezil significantly increased mean flow velocity in some arteries.

Memantine and donepazil improve cognitive function in patients with vascular dementia. Rivastigmine, galantamin and donepezil have some effects on cerebral blood flow.