Outcomes of Alzheimer's disease therapy with acetylcholinesterase inhibitors and memantine.
BACKGROUND
Alzheimer's disease (AD) is a world-wide health problem with implications for an increasing number of people and countries. Populations suffering from AD financially strain the healthcare budgets of rich and poor countries alike. Moreover, no effective treatment is available and current drugs merely slow the progression of cognitive function deterioration and overall health status toward an inevitable end point. An increasing number of novel approaches have been tested in numerous clinical trials, but none of them has proved safe and effective for treating AD.


METHODS
This review summarizes all currently available compounds (donepezil, rivastigmine, galantamine, memantine) for the management of AD, concentrating on clinical aspects such as the mechanisms of action, pharmacokinetics, pharmacodynamics and clinical trials. This review also considers the mechanisms and side effects to provide perspective on current treatment options.


CONCLUSIONS
Novel approaches in the treatment of AD are being intensively tested, but so far without any major success. Patients diagnosed with AD still mostly benefit from four compounds to significantly improve cognition functions and overall health and help manage other symptoms or even prolong the symptom-free period.
University of Defence, Department of Toxicology, Faculty of Military Health Sciences , Hradec Kralove , Czech Republic.
Filip
F
Zemek
Lucie
L
Drtinova
Eugenie
E
Nepovimova
Vendula
V
Sepsova
Jan
J
Korabecny
Jiri
J
Klimes
Kamil
K
Kuca
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000818:Animals; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D015195:Drug Design; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008559:Memantine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists; D008559:Memantine
Alzheimer's diseases; acetylcholinesterase; donepezil; galantamine; memantine; rivastigmine