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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 glutamate levels.

  • 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 disturbances.

Treatments include:

  • 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.

  • Antidepressants.

  • Anxiety-reducing medications.

  • Antipsychotic medications.

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Reviewed on June 07, 2004

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