Rioux Stéphane
Hôpital Laval, Québec.
Rev Med Suisse Romande. 2003 Jul;123(7):471-4.
Acetylcholinesterase inhibitor drugs. The approach to the treatment of Alzheimer's dementia has been greatly modified by the acetylcholinesterase inhibitor drugs, first donepezil (Aricept) and then rivastigmine (Exelon) and galantamine (Reminyl), and the ever-increasing number of demented people forces us to be familiar with their use. All three drugs practically share the same contraindications. Their side effects are directly related to the increased amount of acetylcholine in the synaptic cleft, they are mainly gastrointestinal in nature, and tend to decrease over time with continued use of the drug. All three medications slightly enhance cognitive performance in most patients, but it is mainly their effect on improving the patients' ability to perform activities of daily living that is remarkable. They are proven to help to delay placement in nursing home, and improve the quality of life for patients and their families. Those drugs nevertheless remain a purely symptomatic treatment, and do not seem to modify the course of the disease.
