Switching previous therapies for Alzheimer's disease to galantamine

Acetylcholinesterase inhibitors (AChEIs) are the most frequently prescribed drugs for the treatment of Alzheimer's disease (AD). To date, donepezil is prescribed most often, but newer AChEIs have become available. Rivastigmin e entered the pharmaceutics market for AD in 2000, and galantamine was appr oved for use in the United States in February 2001. Some patients with AD m ay already be taking a cholinesterase inhibitor, but they or their caregive rs may want to change therapies for various reasons, such as lack of effica cy or poor tolerability. Therefore, defined protocols far discontinuing one therapy and initiating another therapy tie, "switching") while maintaining efficacy and minimizing cholinergic toxicity will be essential. A post-hoc analysis of a clinical trial that enrolled patients with and without previ ous exposure to AChEIs indicated that the efficacy and tolerability of a se cond and different cholinesterase treatment were similar in both subpopulat ions of patients. These findings suggest that discontinuation of prior AChE I treatment is not predictive of future poor response to an effective treat ment.