The clinical guideline on dementia says that donepezil, galantamine and rivastigmine can be given to patients with mild Alzheimer’s if symptoms cause significant distress and other treatments are ineffective or unsuitable.
However, NICE also published its final technology appraisal on cholinesterase inhibitors which stands by its original, controversial decision that the drugs are only cost-effective in patients with a mini-mental state examination score of 10-20.
Last week, three manufacturers of the drugs said they were seeking a judicial review of the decision.
London GP Dr Steve Iliffe, a member of the NICE dementia guideline development group, said: ‘The guidelines on medication use are particularly helpful because they emphasise the importance of clinical judgement about impairment and counsel against a mechanistic reliance of test scores.’
