Acetylcholinesterase inhibitors and memantine delay cognitive decline in dementia: Study.
The efficacy of acetylcholinesterase inhibitors and memantine in the symptomatic treatment of Alzheimer's disease is well established. Randomised trials have shown them to be associated with a reduction in the rate of cognitive decline. Exploring how well these drugs perform in a real world scenario, Nemanja Vaci et al have shown that 68% of individuals respond to treatment with a period of cognitive stabilisation before continuing their decline at the pre-treatment rate. The study was recently published in The British Journal of Psychiatry.
The evidence for cholinergic loss in dementia that correlates with severity of disease led to the development inhibitors of the enzyme acetylcholinesterase. Three acetylcholinesterase inhibitor (AChEI) agents have been approved (donepezil, rivastigmine and galantamine) for the treatment of mild to moderate forms of Alzheimer's disease.
Memantine is the fourth available option which is thought to counteract some of the neurotoxicity in Alzheimer's disease through antagonism of the glutamate N-methyl-D-aspartate (NMDA) receptor. In contrast to AChEIs, memantine is approved for the treatment of the more advanced forms of Alzheimer's disease.
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