Alzheimer’s and possible Combination Therapy to Improve the Quality of Life

Authors

Auguste Deter. Alois Alzheimer's patient in No...

Auguste Deter. Alois Alzheimer’s patient in November 1901, first described patient with Alzheimer’s Disease. (Photo credit: Wikipedia)

Alzheimer’s

  • it is the most common form of dementia
  • it is also known as simply Alzheimer’s, and Senile Dementia of the Alzheimer Type (SDAT)
  • it’s a progressive neurologic disease of the brain i.e., the disease gets worse as it develops
  • amyloid plaques develop within the structure of the brain resulting brain cell death
  • causes irreversible loss of neurons, loss of intellectual abilities, including memory and reasoning
  • have a deficiency in the levels of some vital brain chemicals called neurotransmitters which are involved with the transmission of messages in the brain
  • it is classified into several stages.
  • some doctors use a 7-stage framework, while others may use a 4, 5 or 6-stage one.
  • a common framework includes 1. Pre-Dementia Stage. 2. Mild Alzheimer’s Stage. 3. Moderate Alzheimer’s Stage. 4. Severe Alzheimer’s Stage.
  • In a 7-stage framework, most patients take from 8 to 10 years to progress through all the seven stages. However, some may live for 20 years after neuron changes first occur.

Signs and symptoms of Alzheimer’s disease

                            Symptoms of                             Alzheimer’s disease                             Signs (examples)
Memory loss Frequently forgetting new information
Problems with familiar tasks Getting confused while cooking or playing a game
Problems with language Forgetting simple words or using wrong words
Disorientation to time and place Getting lost in a familiar neighborhood
Poor judgment Dressing inappropriately for the weather
Problems with abstract thought Trouble with simple math
Misplacing things Putting an iron in the freezer
Changes in mood and behavior Unusual bouts of anger or rapid mood swings
Changes in personality Becoming overly confused, suspicious, afraid, or dependent
Loss of initiative Lack of interest in usual activities
Risk factors may include
There is no current cure for Alzheimer’s, although there are ways of slowing down its advance and helping patients with some of the symptoms.
Current Alzheimer’s disease Management includes two ways:
  • Acetylcholinesterase inhibitors
  • Glutamate path modifiers.

They both work differently in the brain

Acetylcholinesterase inhibitors – work by helping to increase the amount of acetylcholine in the brain – a chemical that is important for memory and learning – by inhibiting the cholinesterase enzyme from breaking down the neurotransmitter acetylcholine resulting in an increase in both the neurotransmitter’s level and duration of action.

Three of the acetylcholinesterase inhibitors approved by the FDA to treat Alzheimer’s disease are:

ARICEPT* (donepezil HCl), approved to treat all stages of Alzheimer’s disease

EXELON** (rivastigmine tartrate), approved to treat mild to moderate Alzheimer’s disease

EXELON PATCH (rivastigmine transdermal system), approved to treat mild to moderate Alzheimer’s disease

RAZADYNE*** (galantamine HBr), approved to treat mild to moderate Alzheimer’s disease

Glutamate pathway modifiers – work differently than the acetylcholinesterase inhibitors. Glutamate is another chemical in the brain that is important for learning and memory.

NAMENDA is currently the only drug of its type approved to treat moderate to severe Alzheimer’s disease.

Unfortunately there is no treatment to cure the disease.  However, though there is no sufficient avidence about its efficacy the combination therapy concept believed to have improved the quality of life of the patients with Alzheimer’s disease.

The most obvious combination is the combination of Nameda (only approved drug that addresses glutamate pathway) and Donepezil (only approved drug that address all stages of the disease) in people with moderate to severe Alzheimer’s disease.

Source

http://www.alz.org/national/documents/topicsheet_treatments.pdf

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001767/

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010397/

http://www.medicalnewstoday.com/articles/159442.php

http://www.namenda.com/Whats-Is-Combination-Therapy/How-It-Works.aspx

*This is for information purpose only, not a medical advice. Consult your physician for any medical advice and usage.

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