Understanding the latest advances in pharmacologic interventions for Alzheimer's disease.
Alzheimer's disease (AD) is a complex medical condition involving abnormalities in multiple biological and environmental domains. Current knowledge suggests that simultaneous intervention in these domains may be the most effective way to help AD patients and their families. Treatments for AD are centered on the inhibition of enzymes responsible for the degradation of acetylcholine--a neurotransmitter that is reduced in AD patients. Four cholinesterase inhibitors have been approved by the United States Food and Drug Administration, three of which are routinely used for the symptomatic treatment of mild-to-moderate AD. Strategies will be reviewed with regard to cognitive, functional, and behavioral domains. Providing a different treatment option for patients with AD, memantine is a low-to-moderate affinity, uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist that has been approved for the treatment of moderate-to-severe AD. The clinical efficacy and tolerability of memantine monotherapy and combination therapy in patients with AD will be presented. Finally, the role of nonpharmacologic intervention will be discussed.
van Dyck
Christopher H
CH
Alzheimer's Disease Research Unit, Yale University School of Medicine, 1 Church Street, New Haven, CT 06510, USA. christopher.vandyck@yale.edu
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use; D002219:Carbamates / Q000009:adverse effects / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D000077265:Donepezil; D004359:Drug Therapy, Combination; D005702:Galantamine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007189:Indans / Q000009:adverse effects / Q000627:therapeutic use; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D048448:Phenylcarbamates; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*; D000068836:Rivastigmine; D016896:Treatment Outcome
D000975:Antioxidants; D002219:Carbamates; D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D016194:Receptors, N-Methyl-D-Aspartate; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine; D008559:Memantine