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Pharmacotherapy of Dementia

  • Sarah A. Chau
  • Celina S. Liu
  • Myuri Ruthirakuhan
  • Krista L. Lanctôt
  • Nathan Herrmann
Living reference work entry
Part of the Mental Health and Illness Worldwide book series (MHIW)

Abstract

Alzheimer’s disease (AD), the most common form of dementia, is a progressive and debilitating condition that causes deterioration in cognition and function, as well as disturbances in behavior. Currently available treatments for AD (donepezil, rivastigmine, galantamine, and memantine) are symptomatic and do not prevent the progression of the disease. These therapies demonstrate modest but consistent benefit for cognition, global status, functional ability, and behavioral disturbances or neuropsychiatric symptoms. The search for disease-modifying interventions has focused largely on compounds targeting the amyloid-β pathway. Current efforts are also geared toward other disease hallmarks such as tau pathology, neuroinflammation, and mitochondrial dysfunction. Given the negative results of disease-modifying drug candidates for mild-to-moderate AD patients, a large number of trials are focusing on the early or prodromal stages of the disease. Neuropsychiatric symptoms, including apathy, depression, agitation and aggression, sleeping disorders and insomnia, and psychotic symptoms, are prevalent in dementia and have a negative impact on both quality of life and caregiver burden. Pharmacological management of specific neuropsychiatric symptoms is also a focus of clinical trials. Given that AD patients are frailer and have more comorbid illnesses, the prescription of psychotropic medications, particularly those of questionable benefit, should be done with careful consideration. In this chapter, we critically examine evidence of the safety and efficacy of currently approved drugs and emerging pharmacotherapies in AD.

Keywords

Alzheimer’s disease Pharmacotherapy Clinical trials Cognition Neuropsychiatric symptoms 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2016

Authors and Affiliations

  • Sarah A. Chau
    • 1
    • 2
  • Celina S. Liu
    • 1
    • 2
  • Myuri Ruthirakuhan
    • 1
    • 2
  • Krista L. Lanctôt
    • 1
    • 2
    • 3
  • Nathan Herrmann
    • 2
    • 3
    • 4
  1. 1.Department of Pharmacology and ToxicologyUniversity of TorontoTorontoCanada
  2. 2.Neuropsychopharmacology Research GroupHurvitz Brain Sciences Program Sunnybrook Research InstituteTorontoCanada
  3. 3.Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.Division of Geriatric PsychiatrySunnybrook Health Sciences CentreTorontoCanada

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