Review Article

Treatment Options in Alzheimer's Disease: Maximizing Benefit, Managing Expectations
Martin R. Farlow^a, Michael L. Miller^b, Vojislav Pejovic<sup>b

a</sup>Indiana University School of Medicine, Indianapolis, Ind., and
^bPrescott Medical Communications Group, Chicago, Ill., USA

Address of Corresponding Author

Dement Geriatr Cogn Disord 2008;25:408-422 (DOI: 10.1159/000122962)

  Key Words

• Alzheimer's disease
• Cholinesterase inhibitors
• Memantine
• Pharmacotherapy
• Combination therapy
• Antioxidants
• Ginkgo biloba

  Abstract

Alzheimer's disease (AD) is becoming an increasingly heavy burden on the society of developed countries, and physicians now face the challenge of providing efficient treatment regimens to an ever-higher number of individuals affected by the disease. Currently approved anti-AD therapies - the cholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist memantine - offer modest symptomatic relief, which can be enhanced using combination therapy with both classes of drugs. Additionally, alternative therapies such as nonsteroidal anti-inflammatory drugs, vitamin E, selegiline, Ginkgo biloba extracts, estrogens, and statins, as well as behavioral and lifestyle changes, have been explored as therapeutic options. Until a therapy is developed that can prevent or reverse the disease, the optimal goal for effective AD management is to develop a treatment regimen that will yield maximum benefits for individual patients across multiple domains, including cognition, daily functioning, and behavior, and to provide realistic expectations for patients and caregivers throughout the course of the disease. This review provides a basic overview of approved AD therapies, discusses some pharmacologic and nonpharmacologic treatment strategies that are currently being investigated, and offers suggestions for optimizing treatment to fit the needs of individual patients.

Copyright © 2008 S. Karger AG, Basel

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  Author Contacts

Martin R. Farlow, MD
Department of Neurology, CL 291, Indiana University School of Medicine
541 Clinical Drive
Indianapolis, IN 46202-5111 (USA)
Tel. +1 317 274 2893, Fax +1 317 274 5873, E-Mail mfarlow@iupui.edu

  Article Information

Dr. Martin Farlow receives grants from Eli Lilly & Co., Novartis, Ono/Pharmanet, Pfizer, Elan Pharm. He also is consultant for Abbott, Accera, Adamas, Cephalon Inc., Eisai Pharm, GlaxoSmithKline, Medivation, Memory Pharm., Merck Res. Labs., Neurochem, Novartis, Octapharma, Takeda, Toyama, Worldwide Clinical Trials and received honoraria from Eisai, Forest, Novartis, Pfizer as a member of Speakers' Bureau.

Drs. Michael Miller and Vojislav Pejovic work for Prescott Medical Communications Group, a contractor of Forest Laboratories, Inc.

Accepted: October 10, 2007
Published online: April 3, 2008
Number of Print Pages : 15
Number of Figures : 0, Number of Tables : 2, Number of References : 183

  Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 25, No. 5, Year 2008 (Cover Date: April 2008)

Journal Editor: Chan-Palay V. (New York, N.Y.)
ISSN: 1420-8008 (Print), eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM

  Drug Dosage / Copyright

Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.