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Wednesday 26th October 2016

Alzheimer’s disease treatment

3rd February 2009

Alistair Burns, professor of old age psychiatry at the University of Manchester reflects on the treatment of Alzheimer’s disease.


Dementia, and its main cause of Alzheimer’s disease, has a devastating effect on sufferers, carers and families.

The treatments are through three cholinesterase drugs – donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl) - while mementine (Ebixa), which acts on the glutamatergic system, is a partial antagonist.

In 2006, the National Institute for Health and Clinical Excellence ruled that the three cholinesterase drugs should only be prescribed to people in the moderate stages of Alzheimer’s disease and that mementine should not be available at the NHS.

There have been challenges to this decision but since then research has moved from the cholinesterase drugs to concentrate on interventions to reduce the toxic effect of the protein amyloid.

Sufferers, and their families, often say on diagnosis that what they want is to halt the decline that goes with the disease.

There is good evidence to show that current treatments for Alzheimer’s disease are safe and help, though it is not possible to predict how people will respond.

But what the publicity surrounding the condition has done is raise awareness and increase the number of people offering themselves for investigation and treatment, including Sir Terry Prachett.

While we may not need more research into the safety and efficacy of existing medication, their availability should be supported.

Yet a big problem remains the ability of people to recognise the disease early enough to get a prompt diagnosis.


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