Currently, there are no medications for Alzheimer’s disease and related dementias that stop or slow disease progression, let alone cure the disorders. There are, however, several therapeutic drugs available in Canada that can slow or delay the worsening of some symptoms for months or even a year or more, depending on the individual patient, and on the stage at which the disease is diagnosed and treatment is started.
Listed below are the types and names of medications which have been shown in clinical trials to help people with Alzheimer’s disease retain certain abilities at higher levels for longer, such as memory, language, and thinking abilities.
Please note that this information is provided as a basic overview of each medication, and is not meant to replace the expert advice of a healthcare professional. Should any of this information conflict with that provided by a physician, nurse, or pharmacist, please defer to the information you receive from these trained professionals.
In Canada, this class of drugs is mainly used to treat symptoms in patients with mild to moderate Alzheimer’s disease. The three currently available drugs in this class are called Aricept®, Exelon®, and Reminyl™.
People with Alzheimer’s disease undergo a progressive degeneration of nerve cells in the brain, particularly those cells that make a chemical called acetylcholine [a-SEA-til-KOH-lean]. This chemical is thought to be important for learning and memory. Cholinesterase inhibitors are believed to reduce the breakdown of acetylcholine, which in turn increases the amount of this essential chemical in the brain.
Another possible explanation for the way these drugs work is that they make the receptors for acetylcholine more responsive, helping enhance the impact of the available acetylcholine in the brain. Though this effect is supported by data from animal experiments, it has yet to be proven in humans. Whatever their mode of action, the potential benefit of these drugs is likely lessened when fewer cells are available to make acetylcholine in the brain, as is the case in the more advanced stages of Alzheimer’s disease.
Research from ongoing clinical trials is demonstrating that a combination of a cholinesterase inhibitor with an NMDA receptor antagonist (described below) can improve outcomes, sometimes to a greater extent than would be predicted from simply adding the anticipated effects of the individual drugs together. Of course, confirmation of these early yet promising results is required from more and larger clinical drug trials
NMDA (n-methyl-D-aspartate) Receptor Antagonists
There is one NMDA receptor antagonist that has been conditionally approved (pending the results of further studies to verify clinical benefit) by Health Canada to relieve the symptoms of moderate to severe Alzheimer’s disease. The drug is called Ebixa®, and is also known as namenda, its generic name.
This drug acts on NMDA receptors, which, along with the neurotransmitter glutamate, are involved in transmitting nerve signals that are thought to be involved in learning and memory. It is believed that Ebixa® might help to normalize the transmission of nerve signals in the brain.
ALZHEIMER ASSOCIATION SUPPORT
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Alzheimer's Resource Centre
The effects of drug treatments are as unique as the patients
with Dr. Howard Chertkow, Bloomfield Centre for Research in Aging