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13 - Evidence-based pharmacotherapy of Alzheimer's disease

Published online by Cambridge University Press:  05 August 2012

Dan Stein
Affiliation:
University of Cape Town
Bernard Lerer
Affiliation:
Hadassah-Hebrew Medical Centre
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

Alzheimer's disease (AD) is increasingly being recognized as a huge worldwide challenge for health and social care organizations, particularly associated with demographic changes in population. This chapter describes the medications currently available to treat AD, and critically reviews the available evidence for their use. Four agents are licensed for the treatment of AD in both Europe and the USA: donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl) and memantine (Ebixa). The pharmacological premise underlying the development of these drugs is derived from the cholinergic hypothesis of AD suggesting that enhancement of levels of acetylcholine, through inhibition of degradation of the existing neurotransmitter, should provide symptomatic relief. Behavioral and psychological symptoms of dementia (BPSD) constitute a spectrum of non-cognitive symptoms found in AD, and include agitation and aggression, psychotic symptoms, mood disorders, disrupted sleep patterns, and behavioral disturbances.
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Publisher: Cambridge University Press
Print publication year: 2012

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