This site uses cookies to measure how you use the website so it can be updated and improved based on your needs and also uses cookies to help remember the notifications you’ve seen, like this one, so that we don’t show them to you again. If you could also tell us a little bit about yourself, this information will help us understand how we can support you better and make this site even easier for you to use and navigate.

Rivastigmine for HIV-associated neurocognitive disorders: a randomized crossover pilot study


Simioni, S., Cavassini, M., Annoni, J.-M., Metral, M., Iglesias, K., Rimbault Abraham, A., Jilek, S., Calmy, A., Muller, H., Fayet-Mello, A., Giacobini, E., Hirschel, B., Du Pasquier, R. A.


Neurology, Volume: 80, No.: 6, Pages.: 553-560

Year of Publication



Objective: To assess the efficacy and safety of rivastigmine for the treatment of HIV-associated neurocognitive disorders (HAND) in a cohort of long-lasting aviremic HIV+ patients.; Methods: Seventeen aviremic HIV+ patients with HAND were enrolled in a randomized, double-blind, placebo-controlled, crossover study to receive either oral rivastigmine (up to 12 mg/day for 20 weeks) followed by placebo (20 weeks) or placebo followed by rivastigmine. Efficacy endpoints were improvement on rivastigmine in the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog) and individual neuropsychological scores of information processing speed, attention/working memory, executive functioning, and motor skills. Measures of safety included frequency and nature of adverse events and abnormalities on laboratory tests and on plasma concentrations of antiretroviral drugs. Analyses of variance with repeated measures were computed to look for treatment effects.; Results: There was no change on the primary outcome ADAS-Cog on drug. For secondary outcomes, processing speed improved on rivastigmine (trail making test A: F(1,13) = 5.57, p = 0.03). One measure of executive functioning just failed to reach significance (CANTAB spatial working memory [strategy]: F(1,13) = 3.94, p = 0.069). No other change was observed. Adverse events were frequent, but not different from those observed in other populations treated with rivastigmine. No safety issues were recorded.; Conclusions: Rivastigmine in aviremic HIV+ patients with HAND seemed to improve psychomotor speed. A larger trial with the better tolerated transdermal form of rivastigmine is warranted.; Classification Of Evidence: This study provides Class III evidence that rivastigmine is ineffective for improving ADAS-Cog scores, but is effective in improving some secondary outcome measures in aviremic HIV+ patients with HAND.;

Bibtex Citation

@article{Simioni_2013, doi = {10.1212/wnl.0b013e3182815497}, url = {}, year = 2013, month = {jan}, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {80}, number = {6}, pages = {553--560}, author = {S. Simioni and M. Cavassini and J.-M. Annoni and M. Metral and K. Iglesias and A. Rimbault Abraham and S. Jilek and A. Calmy and H. Muller and A. Fayet-Mello and E. Giacobini and B. Hirschel and R. A. Du Pasquier}, title = {Rivastigmine for {HIV}-associated neurocognitive disorders: A randomized crossover pilot study}, journal = {Neurology} }


aids dementia complex, dementia, double-blind method, drug effects, drug therapy, executive function, female, hiv, humans, male, middle aged, neuroprotective agents, neuropsychological tests, phenylcarbamates, pilot projects, related, rivastigmine, therapeutic use

Countries of Study


Types of Study

Randomised Controlled Trial

Type of Outcomes


Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime