Alzheimer's Cure Elusive Despite Progress
Ronald Reagan's struggle shows how far we've come, how far we have to go.
Today's Alzheimer's Disease Treatments
While waiting for tomorrow, a lot of exciting Alzheimer's
treatments are available today.
Currently available drugs slow Alzheimer's process. Patients
who were on a sharp decline often stabilize. Today, there are several ways to
treat Alzheimer's disease:
Aricept, Exelon, and Reminyl. These are the
cholinesterase inhibitors. Cholinesterase breaks down an important brain
chemical called acetylcholine. These drugs keep this from happening.
Unfortunately, this doesn't stop brain cells from dying. About half of the
patients who take these drugs see a modest improvement in mental function.
(Tacrine, the first member of this class of drugs, now rarely is used because
it sometimes causes liver damage.) In April 2005, Reminyl's label
was changed to include information about the deaths of 13 elderly patients who
were taking the drug during a study. The deaths were due to various causes,
including heart attack and stroke.
Namenda, approved in October 2003, is the newest kind of
Alzheimer's drug. It's called an NMDA receptor antagonist. The NMDA receptor is
a kind of dimmer switch that controls the actions of a brain chemical called
glutamate. Glutamate plays a major role in learning and memory. Too much of it
kills brain cells. Too little makes them grind to a halt. Namenda helps balance
Vitamin E. Everybody's brain is under constant attack
from destructive oxygen molecules called free radicals. We've evolved effective
ways to fend off these attacks. But Alzheimer's disease and the normal aging
process seems to lower these defenses. Antioxidant compounds -- especially
vitamin E -- may reinforce this crumbling line of defense.
Other treatments don't affect Alzheimer's disease itself but
can help reduce the agitation that often distresses patients and their
caretakers. Agitation is the word used to describe the many behaviors that pop
up as Alzheimer's disease progresses. These include personality changes, sleep
disturbances, delusions, hallucinations, restlessness, and emotional
Behavioral interventions. Sometimes it helps to simplify a
patient's environment and routine tasks. Patients may need extra rest between
stimulating events. Labels or verbal cues can reduce disorientation.