Effective pharmacologic management of Alzheimer's disease.
In order to assist physicians in the effective pharmacologic management of this challenging population, evidence-based pharmacologic treatment algorithms for the different stages of Alzheimer's disease have been developed. Evidence-based guidelines outlining pharmacotherapeutic strategies can be systematically implemented to optimize outcomes for patients in different stages of Alzheimer's disease. The first step toward the best possible long-term management is early diagnosis of Alzheimer's disease, thereby facilitating early initiation of cholinesterase inhibitor treatment, which may stabilize/reduce the rate of symptomatic cognitive and functional decline. Cholinesterase inhibitor therapy with rivastigmine, donepezil, or galantamine is endorsed as standard first-line therapy in patients with mild-to-moderate Alzheimer's disease. The N-methyl-D-aspartate receptor-antagonist, memantine, may be used as monotherapy or in combination with a cholinesterase inhibitor for patients with moderate Alzheimer's disease, and as monotherapy for patients with severe Alzheimer's disease. During treatment, cognitive and functional status should be monitored over 6-month intervals, and pharmacologic therapy should ideally be continued until there are no meaningful social interactions and quality of life has irreversibly deteriorated.
Farlow
Martin R
MR
Department of Neurology, Indiana University School of Medicine, Indianapolis 46202-5111, USA. mfarlow@iupui.edu
Cummings
Jeffrey L
JL
D000375:Aging / Q000502:physiology; D000465:Algorithms; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D019468:Disease Management; D004359:Drug Therapy, Combination; D006801:Humans; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors