ABSTRACT
This chapter discusses that the agents used in replacement therapy followed by the combination therapy and the therapies aimed at modifying the course of the disease. There are currently two main approaches to the treatment of Alzheimer’s disease. The first, presumably a palliative one, is neurotransmitter replacement, most commonly based on the cholinergic deficits demonstrated in this disease. The second is a neuroprotective approach, aimed at protecting neurons from further degeneration and thus stopping cognitive deterioration. Alzheimer’s disease patients consistently show cholinergic abnormalities correlating with cognitive impairment. Oral administration of oxotremorine to Alzheimer’s disease patients did not improve cognitive function and was associated with significant side effects including depression and anxiety. Although muscarinic receptors play a significant role in memory, there is evidence to suggest involvement of nicotinic receptors as well in Alzheimer’s disease. Most studies using parenteral administration of physostigmine have documented transient cognitive improvement in at least a subgroup of patients with Alzheimer’s disease.
