In the treatment of Alzheimer’s disease, where there is no cure discovered yet, even a small improvement in symptoms can often be perceived as a big success. As with many other health disorders, the earlier Alzheimer’s is detected – the more effective treatment could be. So, when Alzheimer’s disease is diagnosed in its early stages – a group of medications, called cholinesterase inhibitors, is usually used as the first-line treatment option for most patients.
From skeptical point of view, it is true that cholinesterase medications work not for every patient with Alzheimer’s, and the improvements caused by such therapy are usually pretty modest; on the other side, when those drugs do work, they can delay worsening of the symptoms for about 6-12 months, not preventing but slowing down the destruction of one’s cognitive abilities, such as memory, language and judgment.
Besides, the improvements provided by cholinesterase inhibitors are usually achieved with small losses in terms of side effects – the drugs of this group are said to be well tolerated by most patients with only mild side effects, such as nausea, diarrhea, indigestion, abdominal pain, and some weight loss.
Since the exact cause of Alzheimer’s disease still remains a secret for scientists, the treatment strategy is somewhere close to playing sea battle game – you can only guess where exactly the ships of your enemy are, and even if you are lucky to destroy one, you never know for sure how many of them still remain…
Cholinesterase inhibitors work against one specific “ship” from the Alzheimer’s fleet. It is called cholinesterase - substance, which “kills” acetylcholine, which is one of the neurotransmitters, helping nerve cells to communicate with each other. Inhibiting or suppressing cholinesterase, the medications of the mentioned class provide the increase in the amount of acetylcholine, which is important for supporting memory and learning processes in human brains.
For the time being, there are three cholinesterase inhibitors approved for treating Alzheimer’s disease. They are Aricept, Razadyne and Exelon in the USA; the generic medications donepezil, galantamine and rivastigmine are also available on the market. All of these medications are considered to be approximately equal in terms of effectiveness against Alzheimer’s. However, some studies showed that donepezil (Aricept) provided greater improvements than other drugs. Hence, Aricept is now approved for the treatment of all stages of Alzheimer’s disease, while Razadyne and Exelon are usually prescribed for mild and moderate conditions.
While some scientists continue to question the expediency of cholinesterase inhibitors use in view of low rate of patients, who respond to such therapy, patients with Alzheimer’s disease are still faced with the fact that there is NO CURE of the disorder. So, it seems reasonable not to neglect medications that DO WORK, even if they work for only 10% of patients, at least until better options are offered…
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