A clinical overview of cholinesterase inhibitors in Alzheimer's disease

Research output: Contribution to journalReview article

74 Scopus citations


This review provides an overview of the three most widely used cholinesterase (ChE) inhibitors: donepezil, rivastigmine, and galantamine. Differences in pharmacologic profiles will be discussed, and consideration will be given to how such differences may relate to and influence the clinical efficacy and tolerability of the various agents. In addition to providing cognitive benefits in patients with Alzheimer's disease (AD), growing clinical evidence also suggests that ChE inhibitors can produce favorable and clinically relevant effects on neuropsychiatric/behavioral disturbances and activities of daily living. Furthermore, recent data indicate that these agents may be effective at all levels of disease severity and for all rates of disease progression. The clinical utility of ChE inhibitors in a wider spectrum of dementias which share a common cholinergic deficit, such as Lewy body dementia, Parkinson's disease dementia, and vascular dementia, is currently under investigation. Beyond symptomatic relief, data suggest that ChE inhibitors may also slow the underlying disease process. As clinical and research experience with these agents continues to accumulate, the differences in their effects will become more apparent and will help physicians tailor ChE inhibition treatment to the needs of the individual patient.

Original languageEnglish (US)
Pages (from-to)93-126
Number of pages34
JournalInternational Psychogeriatrics
Issue numberSUPPL. 1
StatePublished - Dec 1 2002


  • Acetylcholinesterase
  • Alzheimer's disease
  • Butyrylcholinesterase
  • Dementia
  • Donepezil
  • Galantamine
  • Rivastigmine

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Aging
  • Psychiatry and Mental health
  • Psychology(all)
  • Clinical Psychology

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