Due to the lack of evidence supporting the efficacy of cholinesterase inhibitors in individuals with MCI, the AAN guideline stated that clinicians who choose to prescribe them for the treatment of MCI must inform patients about the lack of evidence supporting this therapy. The guideline also indicated that clinicians should recommend that individuals with MCI engage in regular physical exercise for cognitive symptomatic benefits; clinicians may also recommend cognitive training, which appears to provide some symptomatic benefit in certain cognitive measures.As MCI may represent a prodromal state to clinical Alzheimers disease, treatments proposed for Alzheimers disease, such as antioxidants and cholinesterase inhibitors, could potentially be useful; however, as of January 2018, there is no evidence to support the efficacy of cholinesterase inhibitors for the treatment of mild cognitive impairment. Two drugs used to treat Alzheimers disease have been assessed for their ability to treat MCI or prevent progression to full Alzheimers disease. Rivastigmine failed to stop or slow progression to Alzheimers disease or to improve cognitive function for individuals with mild cognitive impairment;  donepezil showed only minor, short-term benefits and was associated with significant side effects. Intervention
Current evidence suggests that cognition-based interventions do improve mental performance (i.e. memory, executive function, attention, and speed) in older adults and people with mild cognitive impairment. Especially, immediate and delayed verbal recall resulted in higher performance gains from memory training.
Elimination half-life is about seven days (169 to 183 hours) over a wide dosing range. Chemistry
The drug is used in form of rolapitant hydrochloride monohydrate, a white to off-white, slightly hygroscopic crystalline powder. Its maximum solubility in aqueous solutions is at pH 2–4. See also
Palonosetron

References
External links
"Rolapitant". Drug Information Portal. U.S. National Library of Medicine. "Rolapitant Injection: MedlinePlus Drug Information". MedlinePlus. 20 August 2020.