We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Effectiveness and Safety of Velnacrine for the Treatment of Alzheimer's Disease:  A Double-blind, Placebo-Controlled Study

Piero G. Antuono, MD; Jean Ravanelli-Meyer, RN, CCRC; Jan Beyer, RN; Walter A. Brown, MD; James Cordoza, MSN; Deborah Guilmette; Steven R. Cohen, MD, PhD; Charles J. Hirsch, MD; Karen G. Cohen, LPN; Jose E. DeLaGandara, MD; Angela Pedraza, MD; Susan Bley, LPN; Dawna L. Dean, MS; Suzanne Manor, MT; Richard F. Holub, MD; Sharon Bright Holub, MPA; Nancy Siciliano, RN; James H. Little, MD; M. Lynn Crismon, PharmD, FCCP; Guadalupe Garcia, PharmD; Richard Margolin, MD; Caryn Crenshaw, RN; Pam Brooks, RN; Ralph W. Richter, MD; Jan Schweiger, RN; Andrew Donnely; Robert A. Riesenberg, MD; Sharon M. Irwin; Robyn L. Cristol; Murray H. Rosenthal, DO; Robert Daigneault, MD; Andrew J. Ferber, RN, MSN; Walter F. Speakman, MD; Jack R. Tomlinson, MD; Penny McDonald, RN; Richard L. Strub, MD; James A. Wilkens, MD; Bruce J. Lepler, MD; Frank P. Zemlan, PhD; Michael A. Keys, MD; Sharon L. Nelson, RNC
Arch Intern Med. 1995;155(16):1766-1772. doi:10.1001/archinte.1995.00430160102010.
Text Size: A A A
Published online

Background:  Alzheimer's disease is characterized by cognitive and behavioral disturbances that are mediated in part by cholinergic brain deficits.

Objective:  To evaluate the long-term effectiveness and safety of an investigational cholinesterase inhibitor, that is, velnacrine maleate, in treating patients with clinically probable Alzheimer's disease (according to the criteria of the National Institute of Neurological Disorders and Stroke [Washington, DC]-Alzheimer Disease and Related Disorders Association [Chicago, Ill]).

Methods:  This was a double-blind, placebo-controlled study. After a single-blind washout period, patients were randomized to receive placebo (n=152), velnacrine maleate, 150 mg/d (n=149), or velnacrine maleate, 225 mg/d (n=148) for 24 weeks. Primary end points were cognitive behavior and memory components of the Alzheimer's Disease Assessment Scale and the Clinical Global Impression of Change scale. Secondary end points were caregiver-rated scales.

Results:  The scores for the cognitive behavior and memory components of the Alzheimer's Disease Assessment Scale deteriorated in the placebo-treated group (P<.05) but not in the velnacrine-treated groups. Between-group comparisons favored velnacrine maleate, 225 mg over 150 mg (P<.05). Findings were similar for the Clinical Global Impression of Change scale and three of the four caregiver-rated scales. Treatment-related adverse clinical events occurred in 36%, 28%, and 30% of patients in the groups that received placebo, velnacrine maleate (150 mg), and velnacrine maleate (225 mg), respectively. The most common adverse clinical event was diarrhea, which rarely interrupted therapy. Treatment was stopped because of reversible abnormal liver function test results (five or more times the upper limits of normal) in 3%, 30%, and 24% of the patients who received placebo, velnacrine maleate (150 mg), and velnacrine maleate (225 mg), respectively.

Conclusions:  Velnacrine produces modest but significant benefits in patients with Alzheimer's disease. Velnacrine maleate (225 mg) is more effective than 150 mg of velnacrine. Both dosages have acceptable safety profiles.(Arch Intern Med. 1995;155:1766-1772)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 44

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.