Tacrine, or Cognex, was the first drug approved by the Food and Drug Administration (FDA)
for the treatment of Alzheimer's. It slows progression of Alzheimer's by increasing levels
of the neurotransmitter acetylcholine. It needs to be taken four times a day and blood
tests for liver function need to be monitored. Up to six out of ten people are unable to
reach the maximum dosage due to side effects.
Donepezil, or Aricept,
was the second drug approved by the FDA to treat
Alzheimer's. It works by raising the level of the chemical
acetylcholine in the brain, slowing progression of some types of
dementias. The dosing is once a day. Side effects include
gastrointestinal discomfort.
Rivastigmine, or Exelon, was approved by the FDA to
treat Alzheimer's. It also, like Cognex and Aricept, increases levels of acetylcholine in
the brain. It is given twice a day and side effects include gastrointestinal discomfort.
Galantamine, or Razadyne, is last in the class of drugs
that raise brain levels of acetylcholine. It has been approved
by the FDA for treating Alzheimer's disease. It is given twice a
day. Side effects include gastrointestinal discomfort.
Memantine, or Akatinol, is an NMDA receptor agent, which
prevents the harm to brain cells from excessive activity of
the chemical glutamate. It was approved by the FDA for
treating moderate to severe Alzheimer's dementia. Although
approved for twice a day use, it may be given once a day.
Intravenous
Immunoglobulin (IVIg) is derived from
the pooled blood of thousands of donors. It
is used for treating various autoimmune
conditions and may have utility in treating
Alzheimer's disease. For more information,
please see the section on
IVIg and
Alzheimer's disease.
Neotropin, as the name suggests, is drug that possibly
promotes the growth of nerve cell processes and maintains nerve cell viability. It is
currently in clinical trials
Nootropics, the first class of agents used for
treatment of memory loss have not been shown to be consistently effective and are not used
routinely in the US.
Alpha-tocopherol, or vitamin E, in doses of 2000
international units has been shown to slow progression of Alzheimer's disease. The drug
works as a free radical scavenger and promotes nerve cell viability.
Selegeline, or Eldepryl,
is an agent that both
raises the levels of certain neurochemicals and promotes nerve cell viability, has been
used in the US for the treatment of Parkinson's disease. It has been shown to be effective
for the treatment of Alzheimer's.
Non-steroidal anti-inflammatory agents, or NSAIDS,
include drugs such as ibuprofen (Motrin, Advil, etc) may
have some utility in preventing Alzheimer's disease.
However, NSAIDs were not effective in treating
Alzheimer's.
Gingko biloba, a free radical scavenger and possible
brain activator, is said to be the third most commonly prescribed drug for the treatment
of dementia in Germany. Preparations of the drug in the US vary and the right dose of the
right preparations may slow progression of some types of memory loss.
Estrogen
may increase or reduce risk for Alzheimer's disease in
women, although data on this topic is exceptionally
confusing and controversial. Please see the section on
menopause and memory for
more on this topic.
B-secretase inhibitors are the newest and
most exciting class of drugs being developed for treating memory loss.
These drugs stop
formation of amyloid plaque and may halt progression of illnesses like Alzheimer's.
Vaccines that dissolve plaques in the brain are
also in development. A clinical trial using a vaccine
developed by Elan was recently stopped because of possible
side effects in some patients.
Certain classes of the B vitamins
are felt to be neuroprotective and are being used in clinical trials for treating memory
loss.
Calcium channel blockers, a class of
drugs used to treat illnesses like hypertension and migraine, have been used to treat
memory loss.
Statins, a class of drugs used to lower cholesterol
levels, may reduce amyloid plaque formation and thus may be helpful in some types of memory
loss.
Clioquinol, an antibiotic withdrawn from the US market
in the 1970s because of adverse effects may reduce plaque formation by binding to zinc and
copper. A recent Swedish study found some benefit in patients with
Alzheimer's disease.