Pharmacotherapy of Neurodegenerative Disorders

Abstract

Neurodegenerative disorders irreversibly and progressively affect specific parts of the CNS and include Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, and Alzheimer’s disease. Parkinson’s disease which affects around 0.5% of the older adults selectively destroys dopaminergic neurons of the basal ganglia, causing tremors, rigidity, and bradykinesia. Therapy constitutes of levodopa, dopaminergic agonists, MAO/COMT inhibitors, and anti-cholinergics. In Alzheimer’s disease, there is deposition of beta-amyloid plaques in the temporal and hippocampal regions of the brain. This is accompanied by degradation of cholinergic neurons which explains the effectiveness of cholinesterase inhibitors like galantamine, donepezil, and rivastigmine. Amyotrophic lateral sclerosis is a degenerative disease of the motor neurons characterized by progressive weakness and spasticity. Riluzole is an agent which reduces excitotoxicity while baclofen and tizanidine treat spasticity.