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Lee, Huh, and Kim: Evidence-Based Treatment of Alzheimer's Disease
Pharmacotherapeutics
Journal of the Korean Medical Association

Journal of the Korean Medical Association 2009; 52(4): 417-425.

Published online: 30 April 2009

DOI: https://doi.org/10.5124/jkma.2009.52.4.417

Evidence-Based Treatment of Alzheimer's Disease

Dong Woo Lee, MD1, Yoon Seok Huh, MD2, Ki Woong Kim, MD2

1Department of Psychiatry, Inje University College of Medicine, Korea.

2Department of Psychiatry, Seoul National University College of Medicine, Korea. kwkimmd@snu.ac.kr

Copyright © 2009 Korean Medical Association

Abstract

The pharmacological treatment of Alzheimer's disease is based on symptomatic therapy of cognitive decline and behavioral problems. Numerous therapies have been investigated for the treatment and prevention of Alzheimer's disease. We reviewed the current evidence-based medical research and guidelines of treatment for Alzheimer's disease. The use of cholinesterase inhibitors (ChEI) and N-methyl-D-aspartate (NMDA) inhibitors can bring about significant but modest therapeutic improvement. There is insufficient evidence to recommend vitamine E, estrogen, ginko biloba, or nonsteroidal anti-inflammatory drugs (NSAIDs) for the prevention or treatment of Alzheimer's disease. This article reviews the available data on current pharmacological treatments through evidence-based medicine.

Keywords: Alzheimer's disease, Pharmacotherapy, Cholinesterase inhibitor, Memantine, Evidence

Figures and Tables

Table 1
Recommendations of California Workgroup on guidelines for Alzheimer's disease management
jkma-52-417-i001

Adopted from final report of California Workgroup on guidelines for Alzheimer's disease management.

Table 2
Principles for precribing ChEIs
jkma-52-417-i002

Table adopted from final report of California Workgroup on guidelines for Alzheimer's disease management.

Table 3
Cholinesterase inhibitors for treatment of mild, moderate and severe alzheimer's disease
jkma-52-417-i003

Table adopted from FDA approved package inserts.

Table 4
Principles for prescribing memantine
jkma-52-417-i004

Table adopted from final report of California Workgroup on guidelines for Alzheimer's disease management.

Table 5
Memantine (N-Methyl-D-Aspartate [NMDA] Receptor Antagonist) for treatment of moderate to severe alzheimer's disease
jkma-52-417-i005

Table adopted from FDA approved package inserts.

References

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crossref
3. California Workgroup on Guidelines for Alzheimer's Disease Management. Guideline for Alzheimer's Disease Management. Final Report. 2008.
4. Fillit HM, Doody RS, Binaso K, Crooks GM, Ferris SH, Farlow MR, Leifer B, Mills C, Minkoff N, Orland B, Reichman WE, Salloway S. Recommendations for best practices in the treatment of Alzheimer's disease in managed care. Am J Geriatr Pharmacother. 2006. 4:S. 9–24.
crossref
5. Kim KW. Korean Association for Geriatric Psychiatry. Cognitive enhancers. Geriatric Psychiatry. 2004. 2nd ed. Seoul, Korea: Jungangmunwha.
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