New Cognitive Enhancers Prevent Breakdown of Acetylcholine
Karl Farcnik, BSc, MD, FRCPC
Michelle Persyko, Psy.D, C.Psych
Psychiatrist,
Division of Geriatric Psychiatry,
University Toronto
Part-time staff,
Toronto Western Hospital
Introduction
Acetylcholinesterase (AchE) inhibitors have now become the medications of choice for first-line therapy in the treatment of Alzheimer's Disease (AD).1 In Canada, there are currently only two drugs that have been approved for the treatment of mild to moderate Alzheimer's Disease; these are donepezil (Aricept)2 and rivastigmine (Exelon).3 They have greater central specificity, and a much more favourable side effect profile, than do earlier AchE inhibitors such as tacrine (Cognex). Their role in the treatment of this disease is significant, since research is showing that they impact not only on the cognitive deficits associated with AD, but also help to preserve activities of daily living (ADL) and decrease behavioural problems. Cognition and ADL are both areas that are affected by Alzheimer's disease.4 Administration of these medications has been shown to be beneficial throughout the disease process. This paper describes donepezil and also rivastigmine, which is the newest AchE inhibitor that has been approved in Canada.
