The U.S. Food and Drug Administration (FDA) has approved five medications (listed below) to treat the symptoms of Alzheimer's disease.
||Mild to moderate
||Moderate to severe
How Alzheimer's drugs work
To understand how Alzheimer's medications work, you first need to understand the communication network in the brain. The picture below depicts nerve cells, or neurons, in the brain. Neurons are the chief cells destroyed by Alzheimer's disease.
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In the brain, neurons connect and communicate at synapses, where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Alzheimer's disrupts this process, and eventually destroys synapses and kills neurons, damaging the brain's communication network.
Current FDA-approved Alzheimer's drugs support this communication process through two different mechanisms:
1) Cholinesterase inhibitors work by slowing down the process that breaks down a key neurotransmitter. Donepezil, galantamine and rivastigmine are cholinesterase inhibitors.
2) Memantine, the fifth Alzheimer's drug, is an NMDA (N-methyl-D-aspartate) receptor antagonist, which works by regulating the activity of glutamate, an important neurotransmitter in the brain involved in learning and memory. Attachment of glutamate to cell surface "docking sites" called NMDA receptors permits calcium to enter the cell. This process is important for cell signaling, as well as learning and memory. In Alzheimer’s disease, however, excess glutamate can be released from damaged cells, leading to chronic overexposure to calcium, which can speed up cell damage. Memantine helps prevent this destructive chain of events by partially blocking the NMDA receptors.
The effectiveness of cholinesterase inhibitors and memantine varies across the population.
Catalyst to progress
The first Alzheimer's Association grants, awarded in 1982, included a study exploring the nerve cell communication network targeted by cholinesterase inhibitors, today's manstay of drug treatment. Association-funded work has contributed important insights to the knowledge base supporting virtually every FDA-approved and investigational Alzheimer's treatment. Learn more about our commitment to research.
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Future treatment breakthroughs
Researchers are looking for new ways to treat Alzheimer's. Current drugs help mask the symptoms of Alzheimer's, but do not treat the underlying disease or delay its progression. A breakthrough Alzheimer's drug would treat the underlying disease and stop or delay the cell damage that eventually leads to the worsening of symptoms. There are several promising drugs in development and testing, but we need more volunteers to complete clinical trials of those drugs and increased federal funding of research to ensure that fresh ideas continue to fill the pipeline.
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