[New therapeutic options in Alzheimer's disease].
BACKGROUND
At present, cholinesterase inhibitors constitute the basis for therapy of Alzheimer's disease (AD); these drugs were rationally introduced given the loss of central cholinergic neurotransmission, even though there are many other systems affected in AD, including glutamatergic pathway.


METHODS
In addition to the loss of central cholinergic neurotransmission, biochemical evidence suggests glutamatergic dysfunction in AD and thus, therapeutic strategies directed at the glutamatergic system may be useful. These drugs include milacemide, cicloserine and ampakines (positive modulation) and memantine (negative modulation). Lithium seems to be a promising agent in AD, although the mechanism of action is poorly understood. Finally anti-inflammatory agents may be another therapeutic approach to AD.


CONCLUSIONS
In addition to drugs acting on the cholinergic system, a large number of drugs with different mechanism could be used for the treatment and prevention of AD.
García-Ruiz Espiga
P J
PJ
Servicio de Neurología, Fundación Jiménez Díaz, Madrid, Spain. pgarcia@fjd.es
Echeverría
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García-Torres
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Contreras
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D000081:Acetamides / Q000627:therapeutic use; D000109:Acetylcholine / Q000378:metabolism; D000544:Alzheimer Disease / Q000188:drug therapy*; D016229:Amyloid beta-Peptides / Q000378:metabolism; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D018698:Glutamic Acid / Q000378:metabolism; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D008559:Memantine / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D017470:Receptors, Glutamate / Q000378:metabolism; D009435:Synaptic Transmission / Q000502:physiology
D000081:Acetamides; D016229:Amyloid beta-Peptides; D000893:Anti-Inflammatory Agents; D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists; D018020:Lithium Compounds; D008996:Monoamine Oxidase Inhibitors; D017470:Receptors, Glutamate; C039332:milacemide; D018698:Glutamic Acid; D000109:Acetylcholine; D008559:Memantine