Читать книгу The SAGE Encyclopedia of Stem Cell Research - Группа авторов - Страница 91

For effective management, the patients and families must be involved early; this strategy will help the patient/family to assess and arrange for the treatment and support services. The leading cause of morbidity and mortality in AD are the concomitant medical conditions and adjuvant therapy that should be put to best medical practices for the welfare of the patient.

By and large the management of AD has been aimed at symptomatic relief. The major drug groups used for treatment include:

Neurotransmitter (acetylcholine and glutamate) modulators; cholinesterase inhibitors (ChEIs) like donepezil, rivastigmine, and galantamine; and the partial N-methyl-D-Aspartate (NMDA) antagonist memantine is of significance especially in mild to moderate disease.

Secondary neuropsychiatric symptoms (e.g., depression, agitation, aggression, hallucinations, delusions, sleep disorders) are associated with cognitive and functional impairment. The psychotropic medications used to treat these secondary symptoms include:

Antidepressants (citalopram, sertraline) enhance the social functioning and relieve depression, however, the adverse effects of orthostatic hypotension and adverse drug effects mandate frequent dose adjustments.

Atypical antipsychotics (risperidone, quetiapine, olanzapine, aripiprazole) may be useful in managing behavioral problems, although a 2006 study in the New England Journal of Medicine found them to be only as effective as placebo.

Anticonvulsants (carbamazepine) effectively control agitation and aggression in randomized trials.

Anxiolytics help to relieve sundowning and insomnia.

Antiparkinsonian agents and beta blockers are also used in AD treatment.