Fast Five Quiz: Alzheimer's Disease

Helmi L. Lutsep, MD

Disclosures

May 06, 2022

Aducanumab is the only disease-modifying medication currently approved by the US Food and Drug Administration for Alzheimer's disease. However, many have questioned the efficacy of the drug, as well as its high cost. All other drugs approved by the FDA modulate neurotransmitters. Donepezil is the only acetylcholinesterase inhibitor approved for use in all stages. Galantamine and rivastigmine are only approved for mild to moderate Alzheimer's disease. The N-methyl-D-aspartate receptor antagonist memantine is approved for treating moderate to severe disease.

Numerous studies have examined the potential of nonsteroidal anti-inflammatory drugs to prevent or delay the conversion of mild cognitive impairment to Alzheimer's disease or slow the progression of dementia. No clear clinical benefit has been established, with some evidence suggesting excess toxicity.

Despite in vitro evidence of a protective effect of estrogen, no data show that women with Alzheimer's disease who are placed on hormone replacement therapy with estrogen have fewer symptoms or progress more slowly than women treated with placebo. Furthermore, a randomized clinical trial of estrogen in cognitively healthy women aged 65 years or older with a first-degree relative with Alzheimer's disease showed that estrogen therapy may actually increase the risk for stroke and dementia.

Some evidence supports modest benefit of low doses of carbamazepine in patients with dementia who have agitation. However, carbamazepine is not routinely recommended for routine use to treat agitation in patients with Alzheimer's disease because of weak evidence and known risks such as drug-drug interactions and poor tolerability with long-term use.

Learn more about the treatment of Alzheimer's disease.

This Fast Five Quiz was excerpted and adapted from the Medscape article Alzheimer Disease.

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