Drug Management of the Dementias

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry


Recent increase in our knowledge and understanding of the pathophysiological mechanisms in AD has led to the identification of potential molecular therapeutic targets for the development of specific drugs. To date these new therapeutic approaches are directed on pharmaceutical compounds undergoing randomised controlled trials. The only successful treatment approach to date that has resulted in significant symptomatic benefit has been the cholinesterase inhibition, which prolongs central acetylcholine activity. Two types of cholinesterases are found in the brain – acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). There is evidence that AChE and BuChE have roles in the regulation of ACh levels. The three choline esterase inhibitors are the foremost treatment options for mild to moderate stages of dementia. Randomised clinical trials have shown consistent but modest benefits in all three outcomes. The present review will summarise the min group of cholinesterases with the main focus on their effects and adverse effects.


Neurodegenerative diseases Alzheimer’s disease Cholinesterase inhibitors Acetylcholinesterase Butyrylcholinesterase NMDA antagonist 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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