title: Plasma Cholinesterase Activity in Alzheimer's Disease.
abstract: Cholinesterase inhibitors (ChEIs) are not allowed to be prescribed in combination, which means that we need to select 1 of 3 ChEIs for use in a patient with Alzheimer's disease (AD). However, there is no quantitative analysis on the differences between these agents. In this article, we propose that plasma cholinesterase activity (pChE) could be used as the standard for differentiating between rivastigmine (Riv) and donepezil (Don) in the management of AD. To date, we have treated 6 patients with Riv 18 mg and 5 patients with Don 5 mg. The pChE is related to low-grade inflammation associated with AD, diabetes mellitus and lipid metabolic dysfunction. Moreover, low pChE is related to liver dysfunction. The pChE must be kept under control. We speculated that Riv is the most appropriate therapy for patients with relatively high pChE, whereas Don is best reserved for those AD patients with relatively low pChE.
authors.affiliation: Department of Psychiatry, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Misa
authors.initials: M
authors.lastname: Hosoi
authors.forename: Koji
authors.initials: K
authors.lastname: Hori
authors.forename: Kimiko
authors.initials: K
authors.lastname: Konishi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tani
authors.forename: Hiroi
authors.initials: H
authors.lastname: Tomioka
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Norihisa
authors.initials: N
authors.lastname: Akashi
authors.forename: Atsuko
authors.initials: A
authors.lastname: Inamoto
authors.forename: Sousuke
authors.initials: S
authors.lastname: Minami
authors.forename: Takuji
authors.initials: T
authors.lastname: Izuno
authors.forename: Kaori
authors.initials: K
authors.lastname: Umezawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Horiuchi
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Hachisu
mesh_terms: D000544:Alzheimer Disease / Q000097:blood*; D000818:Animals; D002802:Cholinesterases / Q000097:blood*; D006801:Humans
chemical_list: D002802:Cholinesterases