García-Ruiz Espiga P J, Echeverría A, García-Torres A, Contreras A
Servicio de Neurología, Fundación Jiménez Díaz, Madrid, Spain.
Rev Neurol. 2006;42(8):478-81.
At present, cholinesterase inhibitors constitute the basis for therapy of Alzheimer's disease (AD); these drugs were rationally introduced given the loss of central cholinergic neurotransmission, even though there are many other systems affected in AD, including glutamatergic pathway.
In addition to the loss of central cholinergic neurotransmission, biochemical evidence suggests glutamatergic dysfunction in AD and thus, therapeutic strategies directed at the glutamatergic system may be useful. These drugs include milacemide, cicloserine and ampakines (positive modulation) and memantine (negative modulation). Lithium seems to be a promising agent in AD, although the mechanism of action is poorly understood. Finally anti-inflammatory agents may be another therapeutic approach to AD.
In addition to drugs acting on the cholinergic system, a large number of drugs with different mechanism could be used for the treatment and prevention of AD.
目前，胆碱酯酶抑制剂构成了阿尔茨海默病（AD）治疗的基础；鉴于中枢胆碱能神经传递的丧失，这些药物被合理引入，尽管AD中还有许多其他系统受到影响，包括谷氨酸能通路。
除了中枢胆碱能神经传递丧失外，生化证据表明AD中存在谷氨酸能功能障碍，因此，针对谷氨酸能系统的治疗策略可能有用。这些药物包括米拉醋胺、环丝氨酸和安帕金（正向调制）以及美金刚（负向调制）。锂似乎是AD中有前景的药物，尽管其作用机制尚不清楚。最后，抗炎药物可能是AD的另一种治疗方法。
除了作用于胆碱能系统的药物外，大量具有不同作用机制的药物可用于AD的治疗和预防。
