Pharmaceutical Therapy

Pharmaceutical agents used to slow the progression of AD include acetylcholinesterase
inhibitors (tacrine, donepezil, rivastigmine, and galantamine).
These agents block the breakdown of neurotransmitters in the brain
and are used to lessen symptoms of mild to moderate AD. Their action extends
cognitive function and improves behavioral symptoms for twelve
months up to two years. Vitamin E or selegiline delays the progression of
AD. Estrogen has been associated with a decreased risk of AD and enhanced
cognitive functioning. Its antioxidant and anti-inflammatory effects enhance
the growth of neuron processes for memory function. Ginkgo biloba
has provided moderate cognitive improvement with few ill effects. Delusions
and hallucinations often develop in moderately impaired patients. In
the absence of agitation or combativeness, the best treatment is reassurance
and distraction. Delusions and hallucinations accompanied by agitation
and combativeness can be treated with low doses of antipsychotic or antidepressant
medications. Medications may also be used to control wandering,
anxiety, insomnia, and depression.