The many faces of dementia: medications for Alzheimer’s
March 24, 2014
Editors note: This article was submitted to The Union by Tor Eckert and reprinted with permission from the Alzheimer's Association. For more information, visit http://www.alzorg, or call the 24-hour helpline at 1-800 272 3900.
"On average, the five approved Alzheimer's drugs are effective for about six to 12 months for about half of the individuals who take them," according to the Alzheimer's Association.
Although there is no cure, current Alzheimer's medications can temporarily slow the worsening of symptoms and improve quality of life for those with Alzheimer's and their caregivers.
The U.S. Food and Drug Administration (FDA) has approved five medications to treat the symptoms of Alzheimer's disease.
Researchers are looking for new ways to treat Alzheimer’s. Current drugs help mask the symptoms of Alzheimer’s, but do not treat the underlying disease.
1. Aricept (donepezil) — Approved for all stages, approved in 1996.
2. Razadyne (galentamine) — Approved for mild to moderate, approved in 2001.
3. Namenda (memantine) — Approved from moderate to severe, Approved in 2003.
4. Exelon (rivastigmine) — Approved from mild to moderate, Approved in 2000.
5. Cognex (tacrine) — Approved for mild to moderate, Approved in 1993.
How the drugs work
To understand how Alzheimer's medications work, you first need to understand the communication network in the brain. Neurons are the chief cells destroyed by Alzheimer's disease. In the brain, neurons connect and communicate at synapses, (the joining points of neurons) where tiny bursts of chemicals called neurotransmitters carry information from one cell to another.
Alzheimer's disrupts this process, and eventually destroys synapses and kills neurons, damaging the brain's communication network.
Current FDA-approved Alzheimer's drugs support this communication process through two different mechanisms:
— Cholinesterase inhibitors work by slowing down the disease activity that breaks down a key neurotransmitter. Aricept, Razadyne, Exelon and Cognex are cholinesterase inhibitors.
— Namenda, the fifth Alzheimer's drug, works by regulating the activity of glutamate, a chemical messenger involved in learning and memory. Namenda protects brain cells against excess glutamate, a chemical messenger released in large amounts by cells damaged by Alzheimer's disease.
Attachment of glutamate to cell surface "docking sites" called NMDA receptors permits calcium to flow freely into the cell. Over time, this leads to chronic overexposure to calcium, which can speed up cell damage. Namenda prevents this destructive chain of events by partially blocking the NMDA receptors.
Researchers are looking for new ways to treat Alzheimer's. Current drugs help mask the symptoms of Alzheimer's, but do not treat the underlying disease.
A breakthrough Alzheimer's drug would treat the underlying disease and stop or delay the cell damage that eventually leads to the worsening of symptoms.
There are several promising drugs in development and testing, but we need more volunteers to complete clinical trials of those drugs and increased federal funding of research to ensure that fresh ideas continue to fill the pipeline.
Tor Eckert has owned and operated an Alzheimer's care home, become an advocate on dementia care with various organizations and was designated as a Healthcare Professional by the Alzheimer's Foundation. He can be contacted at TorEckert@sbcglobal.net or call 530-277-0879.
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