Efficacy of the combined use of donepezil with either quetiapine or sodium valproate in patients with Alzheimer's disease with behavioral and psychological symptoms of dementia, and their effects on vascular endothelial growth factors

The present study aimed to compare the clinical efficacy of donepezil combined with quetiapine and with sodium valproate on behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD), and to explore the changes and clinical value of vascular endothelial growth factor (VEGF). For this purpose, a total of 131 patients with AD admitted to the Infirmary of Shandong Agricultural University from January, 2017 to January, 2019 were included, of which 60 treated with donepezil combined with quetiapine were designated as group A, whereas 71 treated with donepezil combined with sodium valproate were designated as group B. The behavioral pathology in the AD rating scale (BEHAVE-AD) was used for the evaluation of the clinical efficacy, the brief psychiatric rating scale (BPRS) for the mental state assessment, and the mini-mental state examination (MMSE) for the assessment of cognitive performance. Any adverse reactions were recorded, and the treatment costs of the drugs were compared. According to the treatment efficacy, the patients were divided into the excellent efficacy group and the poor efficacy group. No significant differences were observed in clinical efficacy, or in the single and total adverse reactions between the 2 groups (P>0.05). The drug treatment costs in group A were significantly higher than those in group B (P<0.05). The expression of VEGF in the excellent efficacy group was significantly higher than that in the poor efficacy group (P<0.05). VEGF was found to negatively correlate with the BEHAVE-AD score before and after treatment (P<0.05). On the whole, the present study demonstrates that both quetiapine and sodium valproate combined with donepezil are effective in the treatment of patients with AD presenting with BPSD; the latter is relatively more cost-effective and thus may be worthy of clinical promotion. Moreover, VEGF negatively correlates with BEHAVE-AD score and can thus be used as a potential predictive marker for the treatment response of patients AD with BPSD.