title: Drug therapy of Alzheimer's disease: realistic or not?
abstract: Drug therapy of Alzheimer's disease is either symptomatic, directed against behavioral manifestations, or specific, presumably directed against some hypothetical pathogenetic mechanism. Symptomatic treatment involves the use of antipsychotic drugs, alone or combined with benzodiazepines, to curb disturbed behavior, restore a normal sleep-wake cycle and improve self-care. Antidepressants can be used cautiously when indicated. Specific treatment has employed many different drugs over the years, including stimulants, cerebral vasodilators, drugs for certain hypothesized causes of the disorder, and drugs assumed to enhance metabolism of the brain, or to protect it against various insults. Of the metabolic enhancing drugs, ergoloid mesylates, nafronyl and piracetam are of the greatest current interest. Ergoloid mesylates have been the most extensively studied, but many questions about this drug, such as its mechanism of action, its proper dose, the proper duration of treatment, and the proper goals of treatment, remain unanswered. Symptomatic treatment is essential, both of the sake of patients and those who attend them. Specific treatment is more controversial. If specific treatment is warranted, ergoloid mesylates might be a reasonable first-choice. A number of experimental approaches aimed at enhancing deficient neurotransmission, or remedying deficient neuropeptides, are currently being investigated. Meanwhile, it is realistic to attempt to do the best one can for the afflicted patients.
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy*; D001921:Brain / Q000378:metabolism; D002986:Clinical Trials as Topic; D004876:Ergot Alkaloids / Q000627:therapeutic use; D006801:Humans; D009435:Synaptic Transmission / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D004876:Ergot Alkaloids; D014665:Vasodilator Agents