Pharmacotherapy for Alzheimerʼs disease and other dementias

Purpose of review This paper reviews recent developments in the pharmacotherapy for Alzheimer's disease and other dementias. Recent findings Important developments over the past year include the publication of two large randomized controlled trials of donepezil that establish long-term efficacy and suggest disease modifying effects. Other studies have attempted to clarify cholinesterase inhibitor treatment issues such as dose response, predictors of response and cost-effectiveness. Cholinesterase inhibitor therapeutic indications can now be clearly expanded to moderately severe Alzheimer's disease and dementia with Lewy-bodies though indications for other neurodegenerative conditions should await further published data. Data on hormone replacement, antiinflammatory and antioxidant therapy still require clarification. While studies suggest that cholinesterase inhibitors provide significant benefit for treating behavioural disturbances in dementia, recently published studies of valproate and antidepressants were disappointing. Summary Significant progress in clarifying the use, indications and long-term benefits of cholinesterase inhibitors has been made. More studies on other cognitive enhancers, prophylactic therapy, and treatment of behavioural and psychological symptoms of dementia are still required.