The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease

Abstract

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Investigational phosphodiesterase inhibitors in phase I and phase II clinical trials for Alzheimer’s disease

“…nucleus basalis of Meynert), as well as progressive degeneration of the cholinergic innervation of the hippocampus and cerebral cortex [7]. At present, there are two classes of drugs approved that are aimed to improve cognition in AD [8][9][10]. The first class comprises the acetylcholinesterase inhibitors, which elevate the endogenous levels of acetylcholine by inhibiting its degrading enzyme.…”

Allosteric Modulation of Related Ligand-Gated Ion Channels Synergistically Induces Long-Term Potentiation in the Hippocampus and Enhances Cognition

“…Diseases of cognitive impairment with polygenic origin, such as Alzheimer's disease or schizophrenia, may not respond adequately to a drug therapy that is selective for a single pharmacological target. In particular, current treatments (donepezil, rivastigmine, and galantamine) that augment the cholinergic neurotransmitter deficits associated with cognitive deficits in Alzheimer's disease may have only marginal cost effectiveness (Green et al, 2005;Loveman et al, 2006;Takeda et al, 2006). Attempts to maximize cost effectiveness for treatment of elderly patients with Alzheimer's disease will be crucial because current treatments may have limited utility and are complicated by excessive pill burden, leading to reduced compliance and poor therapeutic outcomes.…”

Bases moleculares de la enfermedad de Alzheimer. Perspectivas de nuevos enfoques terapéuticos

“…Los tres inhibidores de colinesterasas de uso común son Donepezil, Galantamina y Rivastigmina (Geldmacher, 2003;Loveman et al, 2006). Esto provino del hallazgo en la década de los 70, de una disminución significativa en la cantidad y actividad de enzimas sintéticas y degradadoras (colin esterasas y acetil transferasas) en las córtices límbicas y cerebrales.…”