title: Anti-dementia medications: current prescriptions in clinical practice and new agents in progress.
abstract: Almost three decades after the publication of the first clinical studies with tacrine, the pharmacological treatment of Alzheimer's disease (AD) remains a challenge. Randomized clinical trials have yielded evidence of significant - although modest and transient - benefit from cholinergic replacement therapy for people diagnosed with AD, and disease modification with antidementia compounds is still an urgent, unmet need. The natural history of AD is very long, and its pharmacological treatment must acknowledge different needs according to the stage of the disease process. Cognitive and functional deterioration evolves gradually since the onset of clinical symptoms, which may be preceded by several years or perhaps decades of silent, presymptomatic neurodegeneration. Therefore, the pharmacological treatment of AD must ideally comprise both a symptomatic effect to preserve or improve cognition and a disease-modifying effect to tackle the progression of the pathological process. Primary prevention is the ultimate goal, should these strategies be delivered to patients with preclinical AD. In this article, we briefly address the pharmaceutical compounds that are currently used for the symptomatic treatment of AD and discuss the ongoing strategies designed to modify its natural course.
authors: Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, and UNESP - Universidade Estadual Paulista, Biosciences Institute, Campus of Rio Claro, São Paulo, Brazil.
authors: Florindo
authors: F
authors: Stella
authors: Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Márcia
authors: M
authors: Radanovic
authors: Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Paulo Renato
authors: PR
authors: Canineu
authors: Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Vanessa J R
authors: VJ
authors: de Paula
authors: Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr. Ovídio Pires de Campos 785, 05403-010 - São Paulo, Brazil.
authors: Orestes V
authors: OV
authors: Forlenza
keywords: Alzheimer’s disease; cognitive impairment; dementia; pharmacology; treatment