The new cholinesterase inhibitors for Alzheimer's disease, Part 1: their similarities are different.
ABSTRACT 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.
SourceAvailable from: Konstantinos Fountoulakis[Show abstract] [Hide abstract]
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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ABSTRACT: Mild cognitive impairment (MCI) is increasingly being conceptualized in the literature as a cognitive disturbance representing a transitional phase between normal aging and dementia. The operational definitions of MCI provide an opportunity for neuropsychologists to detect subtle deficit and monitor cognitive status sequentially in order to determine rate and degree of progression. More importantly, clinical and neuropsychological studies are needed that can better characterize which MCI patients are at greatest risk for conversion to dementia. Preliminary data has also designated MCI as a potential indicator for initiation of pharmacotherapy, with the objective of decelerating rate of progression to dementia. Current criteria and clinical issues related to MCI are discussed, with the objective of better familiarizing clinicians with this syndrome and fostering ongoing investigations.Archives of Clinical Neuropsychology 01/2004; 19(1):11-27. DOI:10.1016/S0887-6177(02)00167-1 · 1.92 Impact Factor