Specific Drug Therapy
Sharon Wyatt Moore
It is impossible to cure all patients; that would
be an achievement surpassing in difficulty even
the forecasting of future developments.
Prior to the 1970s, approved treatment options were unavailable for the memory problems associated with dementia. Although few such drugs are commercially available at this time, many areas of research appear promising for new drug development. Extensive efforts are underway to understand the mechanisms of nervous system pathology of patients with Alzheimer's disease, and such insights are critical to develop effective treatments. It is now clear that there is not one specific defect in the disease, but several processes or pathways are affected. Certainly, the progress researchers have made in the last 20 years gives families hope for future breakthroughs to ease the suffering now endured. New efforts are also underway to determine whether some medications may help prevent Alzheimer's disease.
This chapter will attempt to provide the reader with an overview of the major medications previously used, currently used, and now under study for the treatment of this disease. None have the prospect of curing Alzheimer's disease, but some patients may experience beneficial effects or delayed worsening. Because all medications have possible side effects, the physician must weigh the risks and benefits with each medication decision.
With any treatment measure, it is especially important for the physician to exclude delirium, psychosis, and potentially reversible causes of dementia before starting therapy.
Hydergine (generic name, ergoloid mesylates) is a combination of four derivatives of ergotoxine and was the first medication approved by the United