Currently there is no cure for Alzheimer's Disease. Scientists are still researching possible routes to try and change the course of the disease and improve the quality of life for dementia patients. At the moment there are various treatments that are able to help with cognitive and behavioural symptoms of the disease.
There are two main types of drugs to delay the progression of Alzheimer's Disease; acetylcholinesterase inhibitors and glutamate inhibitors. Acetylcholinesterase inhibitors include Aricept (donepezil hydrochloride), Exelon (rivastigmine) and Reminyl (galatamine). Whereas, glutamate inhibitors includes Ebixa (memantine).
- How do these work?
Aricept, Exelon and Reminyl - Research has been undertaken that shows the brain of Alzheimer's patients demonstrates a loss of nerve cells that use the neurotransmitter called acetylcholine. The increased loss of these nerve cells leads to an increased severity of the disease. These drugs prevent the enzyme acetylcholinesterase from breaking down acetylcholine in the brain. This will lead to an increased amount of acetylcholine in the brain, increasing communication of the nerve cells that use acetylcholine. This treatment could improve and stabilise some of the symptoms seen in Alzheimer's patients. These three drugs work in a very similar way, although one might be better suited to an individual than another, possibly due to some of the side effects.
Ebixa - Treatment using Ebixa is different and a lot more complex than using the acetylcholinesterase inhibitors. Ebixa blocks another chemical messenger called glutamate. Glutamate is released in excess when a patient's brain is damaged by Alzheimer's Disease. The release of glutamate can damage brain cells further, treatment with Ebixa can reduce this.
Are these drugs effective?
At the moment acetylcholinesterase inhibitors are available on the NHS to patients with mild to moderate Alzheimer's disease, but not yet for people with severe Alzheimer's. About 40-60% of people with Alzheimer's disease can benefit from acetylcholinesterase inhibitor treatment, although this treatment may not be effective for everyone and the improvements may only be temporary. Many people on this treatment do see a vast improvement in motivation, confidence, memory and thinking.
Ebixa has been shown to temporarily slow down the progression of the symptoms of patients in the middle to later stages of the disease. Ebixa is licensed to treat patients with moderate to severe Alzheimer's and may also help with the treatment of behavioural symptoms.
Generally the acetylcholinesterase inhibitors and Ebixa can be tolerated in patients with Alzheimer's.
Every patient will have different side effects if they have any at all. Some side effects of Aricept and Exelon are vomiting, dizziness, nausea, headaches, stomach cramps, insomnia and loss of appetite. Ebixa side effects include tiredness, headaches, increased blood pressure and sometimes confusion and hallucinations.
Ebixa is not recommended for patients with kidney problems, as this is yet to be shown that this treatment would be safe for such patients. Also caution needs to be taken when dealing with patients with epilepsy and heart conditions.
As well as drug treatments your GP may suggest some treatments that will help you deal with the symptom's of the disease, for example memory loss, emotional symptoms and behaviour changes.
- Cognitive development programme - Using memory and thinking exercises to stimulate multiple processes.
- Behavioural management - Treating symptoms such as depression and aggression.
- Early psychological therapy - Helping patients come to terms with the disease and the loss of control.
- Group therapy - Involving family and friends and other sufferers, to help patients feel happier and less isolated.