What is the Benefit of Acetylcholine Esterase Inhibitors?
For clinical use, most progress in the treatment of Alzheimer’s Disease has been made with acetylcholine esterase inhibitors. Tetrahydroaminoacridine (Tacrine), recently released in the United States, has been marketed for patients with mild to moderate disease. Recent randomized trials of tacrine in England, Canada, and the United States provide a basis for using this medication in some patients. Of note, patients studied have had mild to moderate dementia (mean Mini-Mental State Examination score of 16 to 18). When seen, improvements have been in cognitive rather than in behavioral function. In summary, studies show that tacrine in doses of 40 to 160 mg per day : • benefits a small subgroup of patients with Alzheimer’s Disease; • improves cognition or slows rate of cognitive decline over a short period, but the magnitude of the improvement is small ; • commonly causes hepatotoxicity that is usually reversible; and most important, • clinical use requires a clear commitment from patien
