Current pharmacotherapies for Alzheimer's disease.

This brief overview will describe some of the current anti-Alzheimer's disease (AD) agents. The relevance of the cholinergic deficit in AD is well-established. Cholinesterase inhibitor (CEI) drugs represent the only FDA-approved primary treatment options for AD as of April 1998. Modest efficacy for AD now has been shown in well-designed clinical trials for six separate CEI agents. Only two, tacrine and donepezil, are currently on the market in the United States, but several others, including rivastigmine (ENA-713), metrifonate, and physostigmine-CR could be available by the end of 1998. Three other treatment strategies are being pursued. Estrogen replacement therapy as a treatment for AD in postmenopausal women is under active investigation. Analogously, clinical studies provide evidence that individuals using anti-inflammatory agents have a lower probability of developing AD. The success of alpha-tocopherol and selegiline in a recently conducted 2-year, double-blinded, placebo-controlled trial supports the hypothesis that oxidative stress plays a role in AD.