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How exactly do different Alzheimer drugs work?



Whether you've just begun on medication to manage the symptoms of Alzheimer's disease or you're taking care of someone with this condition, learning a little more about Alzheimer's does less mysterious and ultimately helps you to feel a bit more in control.

First, a little bit about Alzheimer's disease.

Alzheimer's disease is a neurodegenerative disorder caused by several things that are not fully understood. Zaldy Tan, MD, medical director of UCLA's Alzheimer's and Dementia Care Program, says SELF. However, the prevailing hypothesis indicates that the accumulation of beta-amyloid proteins forms a type of plaque in the brain that causes damage. In addition, tau protein strands accumulate to form " Tangles ", which affects the ability of brain cells to transport nutrients and other compounds.

This initially occurs in areas of the brain that are associated with short-term memory, leading to cell death and associated neurological symptoms. Tan. The first symptoms that are noticeable are those associated with memory, such as forgetting where you left something, or feeling lost in a familiar place. .

But as these panels and tangles spread throughout the brain, further damage develops and causes further symptoms such as difficulty swallowing, repetitive movements, walking and hallucinations.

There are two main classes of Alzheimer's drugs, for whose treatment the FDA approved symptoms in certain stages of the disease.

There are currently no treatment options that can affect the proteins thought to be at the root of Alzheimer's disease Tan. However, there are several medications available to help patients treat their symptoms. Instead of targeting these proteins, these drugs alter the way neurotransmitters work in the brain.

There are two main types of drugs:

cholinesterase inhibitors:

These drugs include galantamine (Razadyne), donepezil (Aricept), and rivastigmine (Exelon). They are approved by the FDA for the treatment of the symptoms of mild to moderate dementia related to Alzheimer's disease and are related to acetylcholine a chemical that plays a role in muscle activity, attention, learning and memory. But instead of acting directly on acetylcholine receptors or simply adding more acetylcholine, they inhibit the action of cholinesterase, an enzyme that normally breaks down acetylcholine. Tan says this leaves more acetylcholine intact, which can improve a patient's memory.

It takes about six weeks to see if the drug works or not, he explains and it does not work for everyone. Even for those, it helps, "it's a very modest answer," he says. "The best case is that the patient's memory and cognitive functions can easily improve from six months to a year ago – it will not turn back time."

As with all medications, these side effects may have effects that may be off-putting to some people. The most common are nausea, vomiting, diarrhea and very vivid dreams, Dr. Tan. Some patients also develop a decreased heart rate. Therefore, these are not medications that someone who already has an irregularly slow heart rate should try. However, another heart condition does not necessarily mean they are banned, he says.

Memantine:

Memantine (Namenda) works with the neurotransmitter glutamate, which is involved in many brain functions, acetylcholine instead of acetylcholine. Patients with dementia show an overstimulation of glutamate NMDA receptors – "No one knows why," says Dr. Tan. The idea is that blocking these receptors prevents this overstimulation and can restore some memory functions. Memantine is only approved for moderate to severe symptoms of Alzheimer's disease.

It is not uncommon for patients to start with a cholinesterase inhibitor and add memantine to the treatment regimen as their disease progresses. As with the cholinesterase inhibitors, it takes about four to six weeks for differences to be noted after the onset of memantine. And the effects are moderate at best.

Dr. Tan says that patients normally tolerate memantine well, but it can cause side effects such as confusion and constipation.

There is also a drug, Namzeric, a combination of donepezil (a cholinesterase inhibitor) and memantine. That's the FDA approval for moderate to severe dementia-related Alzheimer's.

Unfortunately, these drugs do not cure Alzheimer's disease, they only help treat the symptoms. Therefore, it is important to keep your expectations within reasonable limits.

These drugs can counteract the symptoms of Alzheimer's disease through neurotransmitter functions, but they do not stop the cell death of brain cells, Dr. Tan. Even then, they can help with other symptoms of dementia like hallucinations or delusions. "It is possible that these drugs, while not as effective at improving memory and cognitive function, may be able to help with some of the behaviors that accompany dementia," he explains amyloid proteins in patients who (due to family history ) may have Alzheimer's disease to prevent the onset of symptoms, Dr. Tan. However, these options are far from available.

If you or someone you look after uses these medicines, it is important to talk to a doctor to weigh the potential risks and benefits of the disease

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