- Prescribing Advice for GPs - https://www.prescriber.org.uk -

NICE publish dementia guidance

The National Institute of Health and Clinical Excellence (NICE) and Social Care Institute for Excellence (SCIE) jointly published a Clinical Guideline containing recommendations on the treatment and care of people with dementia in health and social care.

At the same time NICE published the widely expected appraisal on donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease.

The BBC has reported on the publication highlighting the controversy surrounding these guidelines and the expected legal challenge.

The appraisal of the drugs available for Alzheimer's disease recommends:

Donepezil, galantamine and rivastigmine can be prescribed for moderate Alzheimer's disease only, and if:

Memantine should not be prescribed for people with moderately severe to severe Alzheimer's disease unless it is being used as part of a clinical trial (research).

Patients already being treated with one of the three drugs recommended in the appraisal should be allowed to continue until the patient, carer and/or specialist decide it is the right time to stop.

Action: Clinicians should be aware of these new recommendations as they are getting substantial media coverage. Audits should be conducted to ensure specialist input is continued and that all four drugs are being used as recommended.