New horizons in management of Alzheimer's disease

At present there is no definitive treatment or cure for Alzheimer's disease, different pharmacological strategies are being actively investigated. Cholinergic therapy and neuroleptic agents represent the available approaches to symptomatic treatment of Alzheimer's disease. The use of cholinesterase inhibitors constitutes the best cholinergic approach to increase acetylcholine levels. Donazapil and Rivstigmine are effective and safe. Tacrine is less used due to its hepatotoxicity. Other cholinesterase inhibitors are still under investigation. Antioxidant therapy, such as Vitamin E and Selegeline, should disrupt or prevent the free radical beta-amyloid recirculating cascade they can prevent or halt pathological process. Oestrogen replacement therapy in post-menopausal woman and non steroidal anti-inflammatory drugs may play a role in slowing or preventing Alzheimer's disease. Nerve growth factor is essential to the health of cholinergic neurons but is not available yet for clinical use. The most promising approaches for the future currently undergoing investigation involve attempts to slow the production of beta-amyloid aggregation. Gene therapy is also under investigation and assessment.