Alzheimer's disease: Clinical treatment options

Comprehensive treatment of Alzheimer's disease (AD) requires thorough careg iver support and a thoughtful and informed use of medications for cognition enhancement, neuroprotection, and the treatment of disturbed behavior. Cur rent treatments such as the cholinesterase inhibitors donepezil and rivasti gmine can slow the progression of cognitive and functional deficits in AD o ver the short term. Sustained improvement and possible disease modification that result from the use of these medications are being evaluated in long- term studies. Treatment with alpha-tocopherol (vitamin E) has been shown to delay the progression of nursing home admission in patients with mild-to-m oderate AD. Although antioxidant, anti-inflammatory, and other treatment st rategies are promising, recent studies of the treatment of AD with estrogen or prednisone have produced disappointing results. For managing the behavi oral symptoms that commonly accompany AD (eg, delusions, aggression, depres sion, anxiety, irritability), various antipsychotics, antidepressants, and anticonvulsants have been effective in carefully selected patients.