The use of selegiline in Alzheimer's patients with behavior problems

Background: Currently there is no regimen for managing the inappropriate behavior seen in Alzheimer's disease that does not cause significant patient sedation. Preliminary evidence suggests selegiline may be effective in behavioral modification without the adverse effects observed with other regimens. The purpose of this study was to document the efficacy of selegiline in Alzheimer's patients with behavior problems. Method: Eight Alzheimer's patients (6 women and 2 men) ranging in age from 50 to 82 years (mean ± SD = 74.0 ± 10.5) were enrolled in this single-blind study. Patients received selegiline 10 mg each day for 8 weeks. Prior to drug administration and at the end of Weeks 1, 2, 4, 6, and 8, patients were evaluated for behavior (BEHAVE-AD), cognitive function (Mini-Mental State Examination), and caregiver stress (Caregiver Burden Scale). Results: Of eight enrolled patients, five were available for analysis. No statistically significant differences were found between mean baseline and mean 8-week scores for any of the three tests. However, clinical significance was noted by improvement in cognition (orientation and recall), caregiver stress, and behavior. Behavior was noted to improve in the areas of paranoid and delusional ideation, hallucinations, activity disturbances, anxiety, and phobias. Conclusion: These data suggest that some Alzheimer's patients with behavior problems may benefit from selegiline therapy.