Clinical description of dementia patients concerned by acetylcholinesterase inhibitor and other drugs in Dr. Soeharto Heerdjan Psychiatry Hospital


  • Muhammad Fahmi Syah Putra Faculty of Medicine, Yarsi University, Jakarta Pusat 10510
  • Nasruddin Noor Departement of Psychiatry, Faculty of Medicine, Yarsi University, Jakarta Pusat 10510


Dementia, Clinical Features, Acetylcholinesterase Inhibitors, Other drugs


Background: Dementia is a syndrome of brain damage caused by cognitive changes due to brain trauma or degenerative, while clinical symptoms in dementia have a variety of both cognitive impairments and non cognitive disorders so that appropriate management in the form of pharmacological interventions is needed.

Objective: To determine the clinical symptoms of dementia patients and use of drug Acetylcholinesterase Inhibitor and other drugs as a treatment in the Dr. Suharto Heerdjan Psychiatric Hospital.

Methods: Quantitative non-experimental or analytical research, and the determination of samples by consecutive sampling method, that is, all medical records that meet established inclusion and exclusion criteria are included in the study until the number of samples is met.

Results: Obtained inclusion criteria of 96 medical records belonging to Dr. Soeharto Heerdjan Psychiatric Hospital patients. with gender of female and male, age presenile dementia (<65 years) and senile dementia (> 65 years) were found. The classification is found in dementia patients including not classified dementia, Alzheimer's dementia, vascular dementia, ytt dementia, parkinson's dementia, and finally dementia ydk, for acetylcholinesterase drugs were founded using donepezil, rivastigmine, and galantamine. The symptoms are obtained with general symptoms of dementia, positive symptoms, and negative symptoms. Comorbid diseases include hypertension, paranoid schizophrenia, residual schizophrenia, tension type headache, anxiety disorders, recurrent depression, and depressive disorders. And other drugs include antipsychotics, antiparkinsonians, mood stabilizers, antidepressants, anxiolytics, anticonvulsants, analgesics, immunosuppressants, antihypertensive agents, vitamins, and N-Methyl-D-Aspartate.

Conclusion: Dementia patients at Dr. Soeharto Heerdjan Psychiatric Hospital has the highest diagnosis of Alzheimer's dementia with the most clinical symptoms in sundowner symptoms and delusional symptoms with some of them having the most comorbid disease in the form of hypertension. As for management, drug use in the acetylcholinesterase group in the form of donepezil and other drugs such as antipsychotic drugs in the form of risperidone or olanzapin, and anti-hypertensive drugs in the form of captopril, amlodipine, and beta blockers are drugs that are often used in patients.


Andriana, et al 2017,’ Menopause dan Alzheimer Disease ‘, Vol. 13 nomor 2 desember 2017

Aupperle, Peter, et al 2206,’ Management agression, agitation, and psychosis in dementa : Focus on atypical antipsychotics’, SAGE Journals 2006, Vol 21.

Bunn, Frances, et al 2014,’Comorbidity and dementia : a scoping review of the literature’, BMC Medicine 2014, 12:192

Christensen, Kockrow. (2006). Adult Health Nursing Fifth Edition.Philadelphia : Mosby Company

Colovic, MB, Krstic, DZ, Lazarevic-Pasti, TD, Bondzic, AM, Vasic, VM 2013, ‘Acetylcholinesterase Inhibitors: Pharmacology and Toxicology’, Current Neuropharmacology, vol. 11, No. 3

Ebert H., Nurcombe B. 2008, Current Diagnosis & Treatment: Psychiatry, Second Edition. McGraw Hill Companies Inc, New York.

Flier, W, et al 2005, ‘Epidemiology and Risk Factors of Dementia’, Neurol Neurosurg Psychiatry 2005;76(Suppl V):v2–v7. doi: 10.1136/jnnp.2005.082867

Foster, PS, Drago, V, Roosa, KM, Campbell, RM, Witt, JC, Hellman, KM 2016, ‘Donepezil Versus Rivastigmine in Patients with Alzheimer’s Disease: Attention and Working Memory’, J Alzheimers Neurodegener Dis 2: 002.

Hartono, Bambang 2000, ‘Demensia (Tinjauan Aspek Definisi, Etiologi, Dermografi, Epidemiologi, dan Faktor Resiko)’, Berkata NeuroSains vol. 2, No. 1:179-188 Oktober 2000

Harvey, RJ, Robinson, MS, Rossor MN, 2003,’ The prevalence and causes of dementia in people under the age of 65 years’, J Neurol Neurosurg Psychiatry 2003;74 :1206–1209

Jones, RW, Soininen, H, Hager, K, Aarsland, D, Passmore, P, Murthy, A, Zhang, R, Bahra, R 2004, ‘A multinational, andomized, 12-week study comparing the effects of donepezil and galantamine in patients with mild to moderate Alzheimer’s disease’, Int J Geriatr Psychiatry 2004;19:58–67

Kaplan I, Sadock J., et al. 2010, Kaplan & Sadock Sinopsis Psikiatri, Jilid I, edisi ke-7 EGC, Jakarta.

Kementerian Kesehatan Republik Indonesia 2015, Pedoman nasional pelayanan kedokteran jiwa, Keputusan Menteri Kesehatan Republik Indonesia,HK.02.02/MENKES/73/2015.

Kementrian Kesehatan Republik Indonesia 2015, Formularium Nasional, Keputusan Menteri Kesehatan Republik Indonesia,HK.02/02/MENKES/523/2015.

Lumbantobing, SM. 2004. Neurogeriatri. Jakarta : Balai Penerbit FKUI

Maslim, Rusdi 2001, Diagnosis Gangguan Jiwa (Rujukan Ringkas dari PPDGJ – III), Jakarta: FK-Unika Atmajaya

McKhann, GM, Knopman, David, SK, Chertkow, H, Hyman, BT, Jack, CR, Kawas, CH, Klunk, WE, Koroshet, WJ, Manly, JJ, Mayeux, R, Mohs, RC, Morris, JC, Rossor, MN, Scheltes, P, Carrillo, MC, Thies, B, Weintraub, S, Phelps, CH 2011, ‘The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease’, Alzheimers Dement. 2011 May ; 7(3): 263–269

Perhimpunan Dokter Spesialis Safar Indonesia 2015 .Panduan Praktik Klinik: Diagnosis dan Penatalaksanaan Demensia. PB. PERDOSSI, Jakarta.

Prince, M, Knapp, M et al 2014. Dementia UK: Second edition – Overview. United Kingdom : Alzheimer’s Society

Tariot, PN, Farlow, MR, Grossberg, GT, Graham, SM, McDonald, S, Gergel, I 2005, ‘Memantine Trearment in Patiens with Moderate to Severe Alzheimer Disease Already Receiving Donezepil’, JAMA, January 21, 2004 – Vol 291, no. 3.

Sadowsky, Carl H. 2005, ‘Switching from Donezepil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study’, Prim Care Companion J Clin Psychiatry 2005;7;43-48

Sjahrir, H, Nasution, D., dan Rambe, H. H. 1999. Demensia. Medan: USU Press

Shumaker, Sally A, et al 2003, ‘Estrogen Plus Progestin and the Incidence of Dementia and Mild Cognitive Impairment in Postmenopausal Women’, JAMA, May 28, 2003 – Vol 289, N0.20.

Stahl, SM 2013, Stahl’s essential psychopharmacology: neuroscientific basis and practical aplications, 4th edn, Cambridge University Press, Cambridge.

Uddin Akter, SF, Abdul Rani, MF, Nordin, MS, Rahman, JA, Aznan, M, Rathor, MY, Rashid, MA, ‘Dementia, Islamic Indication and Scientific Evidence’ , International Journal of Applied Science and Technology, Vol. 1 No. 5; September 2011

Warrent, T D. 2009,’ Risk for depression and cognitive deterioration in older individuals: The important role of past and present environtmental influences’. The American Journal of Psychiatry. Vol 166: 12 hal. 1312-1314

Wreksoatmodjo, Budi Riyanto 2014, ‘Beberapa Kondisi Fisik dan Penyakit yang Merupakan Faktor Risiko Gangguan Fungsi Kognitif ’, CDK-212/ vol. 41 no. 1, th. 2014