How Alzheimer Disease Medications Work

Alzheimer's disease is a complex neurodegenerative disorder characterized by cognitive decline and memory loss. Current medications aim to manage symptoms, slow disease progression, or both.

Gold Standard: Cholinesterase Inhibitors

• Donepezil (e.g., Aricept): The gold standard for Alzheimer's treatment, cholinesterase inhibitors work by increasing acetylcholine levels in the brain.

• Acetylcholine is a neurotransmitter involved in memory and cognitive functions.

• By inhibiting the enzyme that breaks down acetylcholine (acetylcholinesterase), donepezil increases its availability, thereby improving cognitive symptoms.

Alternatives: Memantine and Other Options

• Memantine (e.g., Namenda): An NMDA receptor antagonist that blocks glutamate's excitatory effects on neurons, reducing neurodegeneration and cognitive decline.

• Glutamate is an excitatory neurotransmitter involved in learning and memory. Excessive glutamate release can lead to neuronal damage.

• Rivastigmine (e.g., Exelon): An acetylcholinesterase inhibitor with a dual mechanism of action, inhibiting both cholinesterase and butyrylcholinesterase enzymes.

Pathophysiology and Treatment Goals

Alzheimer's disease is characterized by the accumulation of amyloid beta plaques and tau tangles in the brain. Current medications aim to manage symptoms, slow disease progression, or both. While there is no cure for Alzheimer's, these treatments can improve quality of life for patients and their caregivers.