ABSTRACT
There were great expectations that muscarinic agonists would be effective in the symptomatic treatment of Alzheimer’s disease (AD), considering the preservation of post-synaptic receptors in contrast to the severe presynaptic cholinergic denervation typical of this type of dementia. Unfortunately, randomized clinical trials (RCT) have so far not been positive. This chapter will examine the rationale for using selective M1 muscarinic agonists in AD and the available data from RCT in terms of efficacy and safety, and will propose new strategies to test the hypothesis that selective muscarinic agonists will be more effective in combination with other classes of drugs for both symptoms and disease modification.
