Standard Prescriptions for Alzheimer’s

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		Cholinesterase Inhibitors Vitamin E

The primary symptoms of Alzheimer’s disease include memory loss, disorientation, confusion, and problems with reasoning and thinking. These symptoms worsen as brain cells die and the connections between cells are lost. Although current drugs cannot alter the progressive loss of cells, they may help minimize or stabilize symptoms. These medications may also delay the need for nursing home care.

There are four drugs approved by the U.S. Food and Drug Administration for the treatment of Alzheimer's disease:

• Tacrine (Cognex®) — approved in 1993

• Donepezil (Aricept®) — approved in 1996

• Rivastigmine (Exelon®) — approved in 2000

• Galantamine (Reminyl®) — approved in 2001

These four medications are in a class of drugs known as cholinesterase inhibitors (pronounced koh lin ES ter ayz). They are designed to prevent the breakdown of acetylcholine (pronounced a SEA til KOH lean), a chemical messenger in the brain that is important for memory and other thinking skills.

The drug works to keep levels of the chemical messenger high, even while the cells that produce the messenger continue to become damaged or die. About half of the people who take cholinesterase inhibitors experience a modest improvement in cognitive symptoms.

For more information, see Cholineterase Inhibitors Fact Sheet in the Resource Center.

Vitamin E supplements are often prescribed as a treatment for Alzheimer’s disease, because they may help brain cells defend themselves from “attacks.” Normal cell functions create a byproduct a called free radical, a kind of oxygen molecule that can damage cell structures and genetic material. This damage, called oxidative stress, may play a role in Alzheimer’s disease.

Cells have natural defenses against this damage, including the antioxidants vitamins C and E, but with age some of these natural defenses decline. Research has shown that taking vitamin E supplements may offer some benefit to people with Alzheimer’s.

Most people can take vitamin E without side effects. However, any change in medications should first be discussed with a primary care physician because all medication can cause side effects or interactions with other medications. A person taking “blood-thinners,” for example, may not be able to take Vitamin E or will need to be monitored closely by a physician.

For more information, see Vitamin E Fact Sheet in the Resource Center.

Reviewed: 10/01/02

© 2002 Alzheimer’s Disease and Related Disorders Association, Inc. All rights reserved.