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Medications for the Treatment of Alzheimer's Disease
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Medications for the Treatment of Alzheimer's Disease
As the lifespan of Americans keeps increasing, the number of Americans with Alzheimer's disease (AD)
is increasing, too. AD currently affects about 4.5 million Americans, and experts expect that number
to increase to 16 million by 2050. Clearly, there is a great need for medications to treat Alzheimer's.
What is Alzheimer's disease?
Alzheimer's disease is a real disease, not just a normal part of aging. The early symptoms
include memory loss, difficulty performing simple tasks, problems with language, and
disorientation to time and place. As the disease progresses, changes in mood, behavior, and
personality occur.
Scientists are making progress in understanding what happens inside the brain of a person with
AD. The brain is an amazingly complex organ, with billions of nerve cells linked together in
equally complex networks. Nerve cells communicate with each other by a special class of
chemicals, neurotransmitters. Neurotransmitters need to be present in appropriate places,
times, and quantities for the brain to function properly. In AD, there are disturbances of
the neurotransmitters acetylcholine and glutamate.
Unfortunately, there is no cure for Alzheimer's and no way to reverse or stop the
loss of brain function. However, there are several drugs which can slow the progress of
the disease.
Cholinesterase inhibitors
Cholinesterase inhibitors are a class of medications which increase the amount
of acetylcholine in the brain. This is important because the nerve cells which produce
acetylcholine degenerate in AD. There are now four drugs of this type on the market in
the U.S.: Cognex (tacrine), Aricept (donepezil), Exelon (rivastigmine), and Reminyl
(galantamine). They are used to treat mild or moderate Alzheimer's. All four have been
shown to improve brain function in clinical trials. Most patients tolerate these drugs
well, although, like all drugs, they have side effects. The most common side effects are
nausea, vomiting, loss of appetite, and increased frequency of bowel movements.
Namenda
Namenda (memantine HCl) is the only drug of its kind approved for the treatment of
Alzheimer's. It works by regulating levels of the neurotransmitter glutamate. It is also
the only drug approved in the U.S. for the treatment of moderate to severe AD. It can be
used alone or in combination with one of the cholinesterase inhibitors. Its side effects
are different from those of the cholinesterase inhibitors and include dizziness, confusion,
headaches, and constipation. Like the cholinesterases, it is generally well tolerated.
Alternative treatments
There are three main alternative treatments which have not been approved by the
FDA. The first is vitamin E, a naturally occurring compound which functions as an
antioxidant. The second, Coenzyme Q10, is another antioxidant. The third, Gingko biloba,
is an herb which is usually taken as a pill.
Additional resources
- Alzheimer's Association provides reliable information and care consultation, and
creates supportive services for families. Their nationwide network of chapters offers a
broad range of programs and services for people with the disease, families, care partners
and professional care providers. ( www.alz.org or 800.272.3900)
- The Alzheimer's Foundation of America focuses on care for Alzheimer's patients,
their caregivers, healthcare professionals, and related community organizations.
(www.alzfdn.org or 1-866-232-8484)
- Alzheimer's Disease Education and Referral Center coordinates clinical trials
of new drugs for Alzheimer's. (www.alzheimers.org/trials or 800-438-4380)
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