[Antidementia Drug Therapy of Alzheimer's Dementia: Status 2018 and Outlook].
[Antidementia Drug Therapy of Alzheimer's Dementia: Status 2018 and Outlook].
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Original abstract
Antidementia therapy: The clinical use of acetylcholinesterase inhibitors (AChE-I) for the symptomatic treatment of mild to moderate Alzheimer's dementia is recognized worldwide, despite its modest effectiveness. AChE-I may be continued to be used into severe stages of the dementia. In moderate to severe Alzheimer's dementia, the NMDA-receptor-antagonist Memantin is indicated.Lewy body dementia is treated as Alzheimer's disease; for Parkinson's dementia, there is a separate indication for rivastigmin. A worsening in motor symptoms may occur. There is no evidence-based antidementia drug therapy for frontotemporal or vascular dementia.Future Therapeutic Strategies: Disease modification is a major focus of current clinical trials. There are several clinical trials targeting anti-amyloid (phase 3) or anti-tau strategies. However, other therapeutic targets are persued, too. In current clinical trials, mild cognitive impairment due to Alzheimer's disease is targeted as the most meaningful study population.Implications for practice: At present, there just is symptomatic anti-dementive drug therapy available for Alzheimer's dementia, Parkinson's dementia and Lewy body dementia. Despite its modest effect sizes, treatment with these drugs is clinically relevant and seems to be cost-effective.