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Published on: February 4, 2012
by Fisher Center For Alzheimer’s Research Foundation
Five drugs have been approved by the U.S. Food and Drug Administration (FDA) for treating the cognitive symptoms of Alzheimer’s disease. Reminyl, Exelon, Aricept and Cognex belong to a class of drugs known as cholinesterase inhibitors. Each acts in a different way to delay the breakdown of acetylcholine, a chemical in the brain that facilitates communication among nerve cells and is important for memory.
Alzheimer’s disease is associated with inadequate levels of this important neurotransmitter. Namenda acts by a different mechanism. It shields brain cells from overexposure to another neurotransmitter called glutamate, excess levels of which contribute to the death of brain cells in people with Alzheimer’s. Click on the fact sheets below to view specific usage information, dosage guidelines, precautions, interactions, and side effects.
DRUGS APPROVED FOR ALZHEIMER’S DISEASE:
Generic Name: memantine
When Approved: 2003
Generic Name: galantamine
When Approved: 2001
Generic Name: rivastigmine
When Approved: 2000
Generic Name: donepezil
When Approved: 1996
Generic Name: tacrine
When Approved: 1993t
* Cognex is rarely prescribed due to serious side effects, including possible liver damage.
In general, Reminyl, Exelon and Aricept are most effective when treatment is begun in the early stages. Namenda is the only drug shown to be effective for the later stages of the disease. They have all been shown to modestly slow the progression of cognitive symptoms and reduce problematic behaviors in some people, but at least half of the people who take these drugs do not respond to them.
While the overall “treatment effect” of these medications is modest, studies show that when they do work, they can make a significant difference in a person’s quality of life and day-to-day functioning (“activities of daily living”). The drugs have different side effects. Some are taken once a day (Aricept), others twice a day (Exelon, Reminyl and Namenda).
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