Effective Pharmacologic Management of Alzheimer's Disease

Martin R. Farlow, Jeffrey L. Cummings

Research output: Contribution to journalReview article

171 Scopus citations

Abstract

In order to assist physicians in the effective pharmacologic management of this challenging population, evidence-based pharmacologic treatment algorithms for the different stages of Alzheimer's disease have been developed. Evidence-based guidelines outlining pharmacotherapeutic strategies can be systematically implemented to optimize outcomes for patients in different stages of Alzheimer's disease. The first step toward the best possible long-term management is early diagnosis of Alzheimer's disease, thereby facilitating early initiation of cholinesterase inhibitor treatment, which may stabilize/reduce the rate of symptomatic cognitive and functional decline. Cholinesterase inhibitor therapy with rivastigmine, donepezil, or galantamine is endorsed as standard first-line therapy in patients with mild-to-moderate Alzheimer's disease. The N-methyl-D-aspartate receptor-antagonist, memantine, may be used as monotherapy or in combination with a cholinesterase inhibitor for patients with moderate Alzheimer's disease, and as monotherapy for patients with severe Alzheimer's disease. During treatment, cognitive and functional status should be monitored over 6-month intervals, and pharmacologic therapy should ideally be continued until there are no meaningful social interactions and quality of life has irreversibly deteriorated.

Original languageEnglish (US)
Pages (from-to)388-397
Number of pages10
JournalAmerican Journal of Medicine
Volume120
Issue number5
DOIs
StatePublished - May 1 2007

Keywords

  • Alzheimer's disease
  • Cholinesterase inhibitor
  • Donepezil
  • Galantamine
  • Management
  • Memantine
  • Pharmacotherapy
  • Rivastigmine

ASJC Scopus subject areas

  • Nursing(all)

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