Treatment of Alzheimer's disease with cholinesterase inhibitors

This article reviews the present status of cholinesterase inhibitors (ChIs) for the treatment of Alzheimer's disease (AD). It then discusses treatment approaches and current and future issues with respect to efficacy and safe ty. The cholinergic system has long been recognized as the most severely affect ed neurotransmitter system in AD, and therapeutic strategies were developed to restore cholinergic function. Although agents with various kinds of pro cholinergic action have been evaluated for efficacy in AD, the ChIs are the only agents consistently to have demonstrated efficacy in numerous multice nter, placebo-controlled trials and to have been approved by many national regulatory authorities.(35) Cholinesterase inhibitors represent the first class of efficacious pharmaco logic approaches for AD, and an approach that is likely to be useful clinic ally for the indefinite future, especially because research on drugs with o ther mechanisms has not advanced as rapidly as had been hoped.