THERAPY OPTIONS IN ALZHEIMER'S DISEASE

SUMMARY The aetiology of Alzheimer's disease and senile dementia of the Alzheimer type (AD/SDAT) are unknown, and primary prevention is thus infeasible. As overactivity in the hypothalamicpituitary-adrenal axis (possibly indicating maladaptation to stress) and vitamin B₁₂ deficiency are common, secondary prevention should focus on stress and dietary factors. Nerve growth factors and ganglioside GM₁ have been used to inhibit progression of the disorder, but this treatment is still at an experimental stage, as are efforts to prevent the formation of amyloid. Breakthroughs in AD/SDAT treatment have been seen in trials with supplementation of neurotransmitter deficits. Tacrine, a drug that inhibits acetylcholinesterase, has proved to have a cognitive-enhancing effect, but this is limited in time and the drug has side-effects. Selective serotonin reuptake inhibitors have a proven effect on the emotional disturbances seen in AD/SDAT.