The New Cholinesterase Inhibitors for Alzheimer's Disease, Part 1: Their Similarities Are Different

Clinical Neuroscience Research Center in San Diego and the Department of Psychiatry at the University of California San Diego, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 11/2000; 61(10):710-1. DOI: 10.4088/JCP.v61n1001
Source: PubMed


Three new cholinesterase inhibitors, donepezil, rivastigmine, and galantamine, all inhibit the enzyme AChE. Rivastigmine also inhibits BuChE, which could lead to additional benefits in late-stage Alzheimer's disease, but also cause more GI side effects at initiation of therapy. Galantamine is also an allosteric modulator of nicotinic receptors, which could lead to additional efficacy for attention and for behaviors mediated by neurotransmitters other than ACh. We are now entering an exciting era where the options for treating the devastating illness Alzheimer's disease are multiplying and creating a foundation upon which new therapies with new mechanisms of action can be built.

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    ABSTRACT: The authors review the literature from the last year examining the benefits of cholinesterase inhibitors in the treatment of behavioral disturbance in Alzheimer's disease (AD) and other dementias. Previous review has indicated that cholinesterase inhibitors have psychotropic properties. We found more evidence to support both the benefits of cholinesterase inhibitors in behavioral disturbance, and that specific behaviors may be selectively responsive to treatment.
    Current Psychiatry Reports 07/2001; 3(3):251-8. DOI:10.1007/s11920-001-0061-7 · 3.24 Impact Factor
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    ABSTRACT: The United Nations projects that the number of individuals with dementia in developed countries alone will be approximately 36,7 million by the year 2050. International recognition of the significant emotional and economic burden of Alzheimer's disease has been matched by a dramatic increase in the development of pharmacological and nonpharmacological approaches to this illness in the past decade. Changing demographics have underscored the necessity to develop similar approaches for the remediation of the cognitive impairment associated with more benign syndromes, such as mild cognitive impairment (MCI) and age-associated cognitive decline (AACD). The present article aims to provide an overview of the most current therapeutic approaches to age-associated neurocognitive disorders. Additionally, it discusses the conceptual and methodological issues that surround the design, implementation, and interpretation of such approaches.
    Dialogues in clinical neuroscience 09/2001; 3(3):191-213.
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