Alzheimer's Treatment: Cholinesterase Inhibitors, Memantine, and Comprehensive Caregiver Support in Neuropsychiatry

The Alzheimer's disease (AD) represents one of the most complex challenges in modern medicine. As the population ages, the prevalence of this neurodegenerative disease continues to rise, underscoring the need for a comprehensive therapeutic approach that combines both medications and holistic care strategies. In this context, cholinesterase inhibitors and memantine have been cornerstones in symptomatic treatment, while emerging therapies aim to modify the disease course.
Cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) and memantine, an NMDA receptor antagonist, are approved treatments that have shown modest improvements in cognition and daily functionality in patients with mild to moderate AD. However, the advancement towards disease-modifying therapies (DMTs) has opened new possibilities. Monoclonal antibodies, such as aducanumab, have recently been approved, marking a milestone in treatment by targeting the accumulation of β-amyloid, one of the pathological features of AD.
In addition to pharmacological treatments, a comprehensive approach to AD must include caregiver support and neuropsychiatry strategies to manage the behavioral and psychological symptoms of dementia (BPSD). Agitation and other neuropsychiatric symptoms are common and can be debilitating, requiring an approach that combines non-pharmacological interventions and, when necessary, the careful use of psychotropic medications.
The future of AD treatment is leaning towards a precision medicine approach, where therapies are personalized according to patients' genetic profiles and biomarkers. This approach promises to enhance treatment efficacy and minimize side effects, offering more patient-centered care.
Conclusions
The treatment of Alzheimer's disease is at a turning point, with significant advances in the development of therapies that not only alleviate symptoms but also seek to modify the disease course. The integration of pharmacological treatments with a holistic approach that includes caregiver support and management of neuropsychiatric symptoms is essential to improve the quality of life for patients and their families. As research progresses, the hope is that these combined strategies will provide a pathway towards more effective and personalized management of AD.
Referencias
- [1] Current and Future Treatments in Alzheimer's Disease
- [2] Advancements in Pharmacological Treatment of Alzheimer's Disease: The Advent of Disease-Modifying Therapies (DMTs)
- [3] A 2023 update on the advancements in the treatment of agitation in Alzheimer's disease
- [4] Navigating the Alzheimer's Treatment Landscape: Unraveling Amyloid-beta Complexities and Pioneering Precision Medicine Approaches
Created 2/1/2025