Currently, there is no cure for Alzheimer's disease (AD). However,…

Currently, there is no cure for Alzheimer's disease (AD). However, there are
medications that can help control its symptoms. In addition, treatments are
also available to help manage agitation, depression or psychotic symptoms
(hallucinations or delusions) which may occur as the disease progresses.
Consult a physician before taking any medications.
   FDA-Approved Drugs

   There are five Food and Drug Administration (FDA)-approved drugs that
   can control symptoms and slow the progression of AD. Four, called
   cholinesterase inhibitors, Cognex® (tacrine), Aricept® (donepezil),
   Exelon® (rivastigmine), and Razadyne® (galantamine), slow the
   metabolic breakdown of acetylcholine, an important brain chemical
   involved in nerve cell communication. These drugs make more of this
   chemical available for communication between cells. This slows the
   progression of cognitive impairment and can be effective for some
   patients with AD. These four medications are all approved for the
   treatment of mild to moderate symptoms of Alzheimer's disease. In
   2006, the FDA approved Aricept for the management of severe AD
   symptoms. The fifth medication, Namenda® (memantine), is approved
   for the treatment of moderate to severe AD. Namenda appears to protect
   the brain's nerve cells against excess amounts of glutamate, a messenger
   chemical released in large amounts by AD-damaged brain cells.

   The effectiveness of these drugs varies from person to person, and some
   drugs may be better tolerated than others by certain individuals. Side
   effects include nausea, dizziness, headache and fatigue.
   All medications are taken orally. However, in 2007, the FDA approved
   the ExelonPatch (rivastigmine transdermal system) to deliver this drug
   through the skin.

   Cognex, though effective, has more adverse side effects and although still
   available, is now rarely prescribed.
Medications to Control Depression, Anxiety and Psychotic
Symptoms
For people in the middle stages of AD, there are also medications to
control depression, anxiety and psychotic behavior, including paranoid
thoughts, delusions and hallucinations. These individuals can also exhibit
aggression, hyperactivity and combativeness. Medications for these
symptoms are considered when non-medication alternatives have failed
and/or these symptoms put the AD patient or others in danger.

Potential Treatments for AD

Many potential AD treatments are being investigated in laboratories and
tested in human clinical trials. Scientists continue basic research on
therapies that could potentially clear the protein plaques in the brain. The
safety and efficacy of possible treatments are being tested on humans,
including drugs that could remove plaques, immunotherapy with beta
amyloid antibodies, non-steroidal anti-inflammatory drugs (NSAIDs) and
statins (drugs used to lower cholesterol). The protective effects of
estrogen, antioxidants (Vitamins A, C and E), ginkgo biloba and omega 3
fatty acids (found mainly in fish such as tuna and salmon) are also being
tested in trials. To date, no consistent results have emerged from various
studies, but further research and future data from rigorous trials should
help clarify the benefit of these and other treatments.

   · Immunotherapy

      In 1999, studies revealed that injection of beta amyloid itself,
      called active immunization, caused laboratory mice to produce
      antibodies against the protein and reduced its accumulation.
      Spurred on by the potential of immunotherapy, some
      pharmaceutical companies started human clinical trials in 2001.
      However, in 2002, the trials were halted when about six percent of
      participants developed a potentially serious side effect, acute
      encephalitis (inflammation in the brain). Autopsies of several
      participants who died of other causes revealed that a large amount
      of beta amyloid had been cleared from their brains, their brain
      volume was lower, and lower levels of tau, another protein related
      to AD, were found in their spinal fluid. Further, for the living trial
  participants who developed antibodies, there was evidence of
  better memory, attention and concentration. More recently, some
  pharmaceutical companies have begun further human trials using
  passive immunotherapy, in which antibodies to a protein rather
  than the protein itself are given to the recipient.

· Non-steroidal anti-inflammatory drugs (NSAIDs)

  Studies suggest that brain inflammation may play a role in damage
  due to AD, and early observations indicated that (NSAIDs) could
  potentially slow its progression. However, human clinical trials of
  three NSAIDs, naproxen (Aleve®), rofecoxib (Vioxx®) and
  celecoxib (Celebrex®) did not delay the advance of the disease.
  (Trials of naproxen were suspended in 2004 due to concerns about
  an elevated risk of stroke and heart attack for participants).
  However, researchers continue to explore the role of other anti-
  inflammatory drugs in the treatment or prevention of AD, since
  different drugs may be effective. In addition, their efficacy may
  depend on how early the drugs are administered.

· Statins

  Several clinical trials are underway to test whether statins,
  cholesterol-lowering drugs, may help slow progression of AD.

· Estrogen

  Research suggests that estrogen taken to manage the symptoms of
  menopause may also protect the brain. Therefore, scientists have
  been interested in whether estrogen could reduce the risk or slow
  the advance of AD. However, clinical trials of those already
  diagnosed with AD, showed that estrogen had no impact on its
  progression. Other studies indicate that women who begin using
  estrogen after age 60 to 65 are at increased risk of developing
  dementia, as well as heart attack and stroke. Estrogen is now only
  recommended for short term use to treat menopausal symptoms.

  Recent research has helped clarify the neuroprotective role of
  estrogen taken by younger women before menopause. According
  to a study published in August 2007, scientists from the Mayo
  Clinic found that women who had one or both ovaries removed
  prior to menopause had an increased long-term risk of dementia or
  cognitive impairment. However, those who underwent ovary
  removal, but also had estrogen treatment until at least age 50 did
  not experience this higher risk. These findings suggest that if taken
  before menopause, the neuroprotective benefits of estrogen may
  outweigh the risks of side effects, such as heart problems, stroke
  and cognitive impairment.

  Women of any age should consult with a physician about the
  individual risks and benefits of undergoing or considering
  hormone replacement therapy.

· Antioxidants

  Vitamin E may offer some protection against cell damage caused
  by free radicals. However, research has produced conflicting
  results and further rigorous scientific study will be needed to
  clarify the role of this antioxidant. Ongoing clinical trials are
  investigating whether vitamins E and C can slow the progression
  of AD. Another clinical trial is examining whether Vitamin E
  and/or selenium can prevent AD or cognitive decline.

  In April of 2005, the New England Journal of Medicine published
  results of a study that compared the use of vitamin E, Aricept
  (donepezil - an AD treatment) and a placebo in delaying
  progression from mild cognitive impairment (MCI) to AD. People
  with MCI experience memory problems, but are able to function
  independently; however, MCI is often a transitional stage that
  leads to the serious cognitive decline of AD. The study found that
  over the course of three years, none of the treatments affected the
  advance of the disease.

· Ginkgo biloba

  Ginkgo biloba, an extract from the leaves of the ginkgo tree, is
  said to have antioxidant and anti-inflammatory properties. It may
  also increase blood flow in the brain. Results vary, but some
  studies suggest that the extract may slow cognitive decline and the
  inability to function that are associated with AD. Ongoing clinical
           trials will help determine if ginkgo biloba can prevent dementia or
           delay cognitive decline in older people.

       · Omega-3 fatty acids

           Omega-3 fatty acids are found mainly in "oily" fish such as
           salmon and albacore tuna, but are also present in certain nuts and
           oils. Scientists believe they may have a protective effect on the
           brain. Clinical trials are underway to test whether these fatty acids
           can slow the both cognitive and functional decline in those with
           mild to moderate AD.


Before taking any medications, over-the-counter drugs, supplements or
herbs, visit a physician for a full medical evaluation. The American Health
Assistance Foundation does not endorse any medications, vitamins or herbs.
A qualified physician should make an informed decision based on each
person's medical history and current prescriptions.




_____________________________________________________________

Some of the above information was obtained from the National Institute on Aging. It
should not in any way substitute for the advice of a qualified healthcare professional and
is not intended to constitute medical advice. For further information, contact Alzheimer's
Disease Research, a program of the American Health Assistance Foundation, at 22512
Gateway Center Drive, Clarksburg, Maryland 20871, call 1-800-437-2423, or visit our
website at www.ahaf.org.


                                                                               January 2008