{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:07:12Z","timestamp":1789549632238,"version":"build-2803163510"},"reference-count":8,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are common and strongly associated with caregiver distress. Switching cholinesterase inhibitors (ChEIs) may be considered when NPS remain clinically problematic. Although switching ChEIs may improve NPS in some patients, published reports describing improvement in delusional jealousy after switching to a donepezil transdermal patch remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report a woman in her 60s with probable AD who developed caregiver\u2010reported delusional jealousy and near\u2010daily marital conflicts during oral galantamine therapy. NPS were assessed using the caregiver\u2010rated Neuropsychiatric Inventory Questionnaire (NPI\u2010Q) at three time points: prior to initiating galantamine (baseline symptoms were predominantly non\u2010psychotic), immediately prior to switching and 6\u2009months after switching. Total NPI\u2010Q severity increased from 4 to 20 and then decreased to 11; total caregiver distress increased from 3 to 31 and then decreased to 13. After switching from oral galantamine, 16\u2009mg\/day, to a donepezil transdermal patch, 27.5\u2009mg\/day, improvements in domain\u2010level severity were observed in the delusions domain, driven mainly by reduced caregiver\u2010rated delusional jealousy, as well as in agitation\/aggression, disinhibition and irritability\/lability. Clinically, the conviction of delusional jealousy gradually diminished with a reduction in conflict frequency; at 6\u2009months, delusional jealousy had almost completely resolved, whereas caregiver\u2010attributed negative self\u2010appraisals (e.g., a persistent belief that she was useless, perceived by the caregiver as delusional) persisted. No psychotropic medications were initiated or dose\u2010adjusted from immediately prior to switching through the 6\u2010month follow\u2010up. Subsequently, the patient became able to attend day care services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that switching from oral galantamine to a donepezil transdermal patch may be associated with improvement in delusional jealousy, selected caregiver\u2010rated NPS domains and caregiver distress in some patients, although causal inference is not possible in a single case and responses may vary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psyg.70217","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:05:36Z","timestamp":1788829536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improvement in Delusional Jealousy and Caregiver Distress After Switching From Oral Galantamine to a Donepezil Transdermal Patch in Alzheimer's Disease: A Case Report"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9268-2052","authenticated-orcid":false,"given":"Hitomi","family":"Matsui","sequence":"first","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"},{"name":"Department of Psychiatry and Behavioral Sciences Graduate School of Medical and Dental Sciences, Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Omori","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Furuta","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.70143"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610210001985"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.1835"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14566"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.23.4.jnpe29"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.102.045773"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2003.11.080"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010220530"}],"container-title":["Psychogeriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70217","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/psyg.70217","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:33:06Z","timestamp":1789547586000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psyg.70217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/psyg.70217"],"URL":"https:\/\/doi.org\/10.1111\/psyg.70217","archive":["Portico"],"relation":{},"ISSN":["1346-3500","1479-8301"],"issn-type":[{"value":"1346-3500","type":"print"},{"value":"1479-8301","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70217"}}