[Pharmacological therapy of senile dementia in Europe and the U.S.A].

This article is a review of the pharmacotherapy of senile dementia in Europe and the United States. Neurophysiological and neuropathological studies of demented elderly have suggested that a change from the attempt to improve cerebral blood flow to the attempt to improve neuronal intermediary (glycolytic) metabolism may be more fruitful therapeutically. Clinical studies of drugs which are direct smooth relaxant vasodilators are compared with studies of drugs claimed to improve neuronal intermediary metabolism in order to test this hypothesis. Comparison of 102 clinical studies of these two types of medications finds that a significant (p less than .005) number of studies of drugs with metabolic action claim positive results than to studies of drugs with vasodilatator action alone. Three new studies addressing questions of dose and spinal fluid effects of these medications are presented. Two studies provide evidence for the superiority of 6 mg/day of dihydroergotoxine mesylate to 3 mg/kg in the elderly. One study suggests that the medication naftidrofuryl, in doses of 800 mg/day and 400 mg/day, may have similar effects.