Alzheimer's Disease (cont.)
What treatment and management options are available for Alzheimer's disease?
The management of Alzheimer's disease consists of medication based and non-medication based
treatments. Two different classes of pharmaceuticals are approved by the FDA for
treating Alzheimer's disease: cholinesterase inhibitors and partial glutamate antagonists.
Neither class of drugs has been proven to slow the rate of progression of
Alzheimer's disease.
Nonetheless, many clinical trials suggest that these medications are superior to
placebos (sugar pills) in relieving some symptoms.
Cholinesterase inhibitors
In patients with Alzheimer's disease there is a relative lack of a brain chemical
neurotransmitter called acetylcholine. (Neurotransmitters are chemical
messengers produced by nerves that the nerves use to communicate with each other
in order to carry out their functions.) Substantial research has demonstrated
that acetylcholine is important in the ability to form new memories. The
cholinesterase inhibitors (ChEIs) block the breakdown of acetylcholine. As a
result, more acetylcholine is available in the brain, and it may become easier
to form new memories.
Four ChEIs have been approved by the FDA, but only
donepezil hydrochloride
(Aricept), rivastigmine (Exelon), and galantamine (Razadyne - previously called
Reminyl) are used by most physicians because the fourth drug, tacrine (Cognex)
has more undesirable side effects than the other three. Most experts in
Alzheimer's disease do
not believe there is an important difference in the effectiveness of these three
drugs. Several studies suggest that the progression of symptoms of patients on
these drugs seems to plateau for six to 12 months, but inevitably progression then
begins again.
Of the three widely used AchEs, rivastigmine and galantamine are only
approved by the FDA for mild to moderate Alzheimer's disease, whereas donepezil is approved for
mild, moderate, and severe Alzheimer's disease. It is not known whether rivastigmine and
galantamine are also effective in severe Alzheimer's disease, although there does not appear to
be any good reason why they shouldn't.
The principal side effects of ChEIs involve the gastrointestinal system and
include nausea,
vomiting, cramping, and diarrhea. Usually these side effects can
be controlled with change in size or timing of the dose or administering the
medications with a small amount of food. Between 75% and 90% of patients will
tolerate therapeutic doses of ChEIs.
Next: Partial glutamate antagonists »
- sertraline, Zoloft - Information on the medication sertraline (Zoloft) a drug used to treat depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and postmenstrual dysphoric disorder. Article includes descriptions, uses, drug interactions, and side effects.
- CT Scan (Computerized Axial Tomography) - CT Scan (Computerized Axial Tomography, CAT scan) is a procedure that assists in diagnosing tumors, fractures, bony structures, and infections in the organs and tissues of the body.
- Depression - Read about depression causes, symptoms, diagnosis, treatment and types, including manic depression (bipolar disorder), postpartum depression and clinical depression.
Latest Medical News
Alzheimer's RSS