Nuvigil improves hallucinations, agitation, apathy in Lewy body dementia

Nuvigil significantly improved overall neuropsychiatric symptoms of dementia with Lewy bodies, particularly visual hallucinations, agitation and apathy, according to data presented at the American Academy of Neurology Annual Meeting.

“Common features of [dementia with Lewy bodies] are excessive daytime somnolence and neuropsychiatric features of visual hallucinations, agitation, apathy, delusions, depression, euphoria and anxiety. While wake-promoting agents have been shown to improve somnolence in this population, no data have been gathered on their effect on neuropsychiatric features,” the researchers wrote.

To assess efficacy of Nuvigil (armodafinil, Cephalon Inc) therapy for neuropsychiatric features associated with dementia with Lewy bodies, researchers conducted an open label pilot study in which 20 individuals with dementia with Lewy bodies received 250 mg of armodafinil for 12 weeks. Caregivers completed an abbreviated measure of neuropsychiatric symptoms at baseline and after 1, 2 and th3 months of therapy. Study participants had a median age of 72 years.

Overall neuropsychiatric morbidity improved after1e month of armodafinil therapy (P = .002). Total Neuropsychiatric Inventory scores also improved from baseline, but change was not statistically significant.

Visual hallucinations (P = .001) and agitation (P = .016) improved after 1 month of armodafinil therapy.

The most notable improvement in Neuropsychiatric Inventory scores was for apathy, which improved after 1 (P = .032), 2 (P = .005) and 3 months (P = .006) of therapy.

There was no significant evidence of improved delusions, depression, euphoria or anxiety.

“Armodafinil therapy resulted in significant improvement of overall neuropsychiatric morbidity, visual hallucinations and agitation early in the course of treatment. There was sustained improvement of apathy throughout the course of treatment. Our pilot study findings suggest improvement on some neuropsychiatric features of [dementia with Lewy bodies] with armodafinil. Open label results must be interpreted with caution due to absence of a control group,” the researchers concluded. – by Amanda Oldt

Reference:

Kuntz KM, et al. Impact of armodafinil therapy on neuropsychiatric features in dementia with Lewy bodies. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.

Disclosure: Kuntz reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.