Alzheimer’s Treatment: Let's Keep Grandma at Home

Alzheimer’s Treatment: Help is on the way

Alzheimer’s treatments continue to improve, offering enormous hope for your friend or family member with dementia. While Alzheimer’s treatments are not curative, they have come a long way toward reducing or delaying the gradual cognitive (mental ability) deterioration associated with the disease. Current Alzheimer’s treatments rely strictly upon medications to forestall the memory declines we all associate with dementia of the Alzheimer’s type. Behavioral interventions are also helpful in managing associated behaviors, but will do nothing to actually effect the progression of the disease. Alzheimer’s treatments now include a recognition of the importance of certain vitamins such as vitamin E, in reducing some of the deterioration in brain cells. Medical science is making great strides toward improved treatments for alzheimers

The U.S. Food and Drug Administration (FDA) has basically approved two classes of medications to treat Alzheimer’s. Cholinesterase inhibitors were the first Alzheimer’s treatments available, developed specifically to slow the deterioration associated with dementia of the Alzheimer’s type. The first of these medications was tacrine (Cognex) which was approved by the FDA in 1993, and is rarely prescribed today because of the side-effects, which included a relatively high potential for liver damage. Also, included within this medication classification is donepezil (Aricept), which was approved in 1996, and was found to have an improved side-effect profile, as well as having a higher level of effectiveness on a larger percentage of individuals with Alzheimer’s disease. Rivastigmine (Excelon) was approved as an Alzheimer’s treatment in 2000, and galantamine (Reminyl) entered the U.S. market in 2001.

These drugs are all geared toward preventing the breakdown of acetylcholine, which is a chemical in your brain called a neurotransmitter, and which is important to your memory and other thinking skills. These medications work to maintain higher levels of this neurotransmitter, even though the cells that produce these chemicals continue to become damaged or die. Approximately one half of the individuals who have taken these medications experience a modest improvement in their thinking skills.

Alzheimer’s treatments which rely upon cholinesterase inhibitors are used to reduce the deterioration in individuals in the early to middle stages of Alzheimer’s. In the past there have been no Alzheimer’s treatments which would assist beyond the early to middle stages until the introduction of Memantine, which was approved by the FDA in October, 2003, and will be available in the U.S. in early 2004.

Memantine will be marketed by Forest Laboratories Inc. under the trade name of Namenda in early 2004. Memantine is the only Alzheimer’s treatment available to treat individuals in the middle to later stages of the disease. It works by regulating the activity of glutamate, another of the brain’s specialized neurotransmitters, which is involved in information processing, storage and retrieval. Glutamate has an important role in learning and memory by controlling the amount of calcium flowing into the neurons (nerve cells) of the brain, enhancing the chemical environment required for information storage.

One of the most interesting factors associated with the introduction of memantine, is that now medications such as Excelon and Aricept may be used in the early to mid-stages, with memantine then being introduced in the middle to later stages of the disease. These medications will provide some level of delay and management of symptoms throughout the entire disease process, which has never previously existed. These drugs are now used to slow down the cognitive deterioration, rather than provide a cure. However, improved management of the disease is just one step closer to a cure.

Information and webpage by Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist)

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