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Cholinesterase Inhibitors

Chapter
Part of the Topics in Medicinal Chemistry book series (TMC, volume 2)

Abstract

Alzheimer's disease is an illness that affects not only the patients themselves but also those around them. Traditionally, cholinesterase inhibitors have been the first-line medications used in treating Alzheimer's disease. There are currently four approved cholinesterase inhibitors: tacrine, donepezil, rivastigmine, and galantamine. Each of these medications has a unique pharmacokinetic profile and mechanism of action. Researchers in the past 5–10 years have accumulated much data on the use of cholinesterase inhibitors. The use of cholinesterase inhibitors may preserve activities of daily living, slow progression of memory loss, and improve behavioral and cognitive symptoms associated with Alzheimer's and other related dementias. There is also some evidence to suggest that the efficacy in some cases may last more than a few years. In addition, there is some evidence that the use of cholinesterase inhibitors may be associated with reduction of caretaker stress. The use of cholinesterase inhibitor, however, does not drastically improve or reverse Alzheimer's disease and their efficacy is not always of clinical significance. This view was reflected by a recent guideline put forth by the National Institute of Clinical Excellence in Great Britain. However, for the millions of patients who are already on cholinesterase inhibitors and have benefited from them, cholinesterase inhibitors remain to be the drug of choice in combating dementia.

Acetylcholinesterase inhibitors Donepezil Rivastigmine Galantamine Tacrine 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  1. 1.Department of Neurology & PsychiatrySt. Louis University School of MedicineSt. LouisUSA

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