ABSTRACT
The efficacy and tolerability of nimodipine, a calcium antagonist selective for the central nervous system, was evaluated in old age dementias in two multicenter, clinical trials. A total of 755 elderly patients suffering from mental deterioration of degenerative or vascular origin were enrolled in the studies. In the first study, 352 patients received nimodipine 30 mg TID orally for 3 months; in the second study, 403 patients received the same treatment for 6 months. In both studies, psychobehavioral instruments showed a highly significant improvement of the global functional state. In hypertensive patients, nimodipine had a synergistic effect with the antihypertensive drugs. These results confirm the therapeutic efficacy and safety of nimodipine in the treatment of old age dementias.
Subject(s)
Dementia/drug therapy , Nimodipine/therapeutic use , Activities of Daily Living , Aged , Aged, 80 and over , Dementia/psychology , Dementia, Vascular/drug therapy , Dementia, Vascular/psychology , Female , Humans , Interpersonal Relations , Male , Memory/drug effects , Mental Processes/drug effects , Nimodipine/adverse effects , Psychiatric Status Rating Scales , Psychomotor Performance/drug effectsABSTRACT
1. The single dose pharmacokinetics of orally administered nimodipine (60 mg) were investigated in normal subjects and in two groups of epileptic patients receiving chronic treatment with hepatic microsomal enzyme-inducing anticonvulsants (carbamazepine, phenobarbitone or phenytoin) and sodium valproate, respectively. 2. Compared with the values found in the control group, mean areas under the plasma nimodipine concentration curve were lowered by about seven-fold (P less than 0.01) in patients taking enzyme-inducing anticonvulsants and increased by about 50% (P less than 0.05) in patients taking sodium valproate. 3. Nimodipine half-lives were shorter in enzyme-induced patients than in controls (3.9 +/- 2.0 h vs 9.1 +/- 3.4 h, means +/- s.d., P less than 0.01), but this difference could be artifactual since in the patients drug concentrations declined rapidly below the limit of assay, thus preventing identification of a possible slower terminal phase. In valproate-treated patients, half-lives (8.2 +/- 1.8 h) were similar to those found in controls.