Effective pharmacologic management of Alzheimer's disease

Am J Med. 2007 May;120(5):388-97. doi: 10.1016/j.amjmed.2006.08.036.


In order to assist physicians in the effective pharmacologic management of this challenging population, evidence-based pharmacologic treatment algorithms for the different stages of Alzheimer's disease have been developed. Evidence-based guidelines outlining pharmacotherapeutic strategies can be systematically implemented to optimize outcomes for patients in different stages of Alzheimer's disease. The first step toward the best possible long-term management is early diagnosis of Alzheimer's disease, thereby facilitating early initiation of cholinesterase inhibitor treatment, which may stabilize/reduce the rate of symptomatic cognitive and functional decline. Cholinesterase inhibitor therapy with rivastigmine, donepezil, or galantamine is endorsed as standard first-line therapy in patients with mild-to-moderate Alzheimer's disease. The N-methyl-D-aspartate receptor-antagonist, memantine, may be used as monotherapy or in combination with a cholinesterase inhibitor for patients with moderate Alzheimer's disease, and as monotherapy for patients with severe Alzheimer's disease. During treatment, cognitive and functional status should be monitored over 6-month intervals, and pharmacologic therapy should ideally be continued until there are no meaningful social interactions and quality of life has irreversibly deteriorated.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aging / physiology
  • Algorithms
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / drug therapy*
  • Cholinesterase Inhibitors / adverse effects
  • Cholinesterase Inhibitors / pharmacology
  • Cholinesterase Inhibitors / therapeutic use
  • Clinical Trials as Topic
  • Disease Management
  • Drug Therapy, Combination
  • Humans
  • Treatment Outcome


  • Cholinesterase Inhibitors