Dementia drugs

Acetylcholinesterase inhibiting drugs such as donepezil, galantamine and rivastigmine are used in the treatment of mild to moderate Alzheimer’s disease. Rivastigmine is also licensed for mild to moderate dementia associated with Parkinson’s disease. Efficacy relates to the cognitive enhancing action of these drugs. Benefit is assessed by cognitive assessment after around 3 months of treatment and treatment should be discontinued in those thought not to be responding. If further cognitive deterioration is measurable 4 to 6 weeks after discontinuation, consideration should be given to restarting therapy. Memantine, a non-competitive NMDA (glutamate) receptor antagonist, can be used for moderate Alzheimer's disease in patients who are unable to take acetylcholinesterase inhibitors, and for patients with severe disease.