Treatment of Alzheimer´s disease: from anticholinesterasic to emerging therapies

Abstract

The therapeutic position against Alzheimer disease was, until the last years, very frequently nihilistic, or limited to the symptomatic control of behaviour disorders, what cause surprise in a disease that has so severe consequences. However, now this position has changed, being at the present, to consider that although the disease has not cure, that does not mean that it has not treatment. Because of the devastating personal and familial effects of the disease, it therapy is of prime importance not only for the patient and her relatives, but also for the society. The therapy of Alzheimer’s disease can be subdivided in primary or preventive, secondary and tertiary or palliative. At the present time, we do not have primary treatments that can prevent the apparition of the disease, but we are at the gateway of a set of therapies that include anti-inflammatory drugs selective for the nervous system, immunologic agents such as the vaccine or the passive immunotherapy, antioxidants, cholesterol synthesis inhibitors, and finally the star drugs, based in the inhibition of BACE and γ-secretase. To these therapies, we can add drugs that partially correct the biochemical disorders present in patients with Alzheimer disease. This therapy is based in drugs with anticholinesterasic properties, and selective muscarinic o nicotinic agonist. This neurotransmitter therapy can reverts more or less, the cognitive and behavioral deficits of Alzheimer´s disease, delay the time to income to institutions and possibly reduce the rate of progression of the disease.