Medicines used in Alzheimer's disease
Drug treatment of Alzheimer's disease
Introduction :

 This booklet is about medicines used to treat Alzheimer's disease. It explains how these drugs work, why they are given, what their side effects are and what their alternative therapies are. In addition to Alzheimer's disease, there are many other causes of memory loss.

Cholinesterase Inhibitors

The following three drugs of this group are licensed in the UK for the treatment of this disease.

Donepezil

Galantamine

Rivastigmine

 Galantamine is not available in Pakistan.

There is no significant difference between these drugs. These usually affect these symptoms, such as memory loss, loss of interest in things and anxiety. These drugs do not completely cure the disease, but some researchers believe that they can slow down the progression of the disease to some extent.

Benefits of these drugs:

They can improve memory, especially remembering new information or helping to remember the first events that come to mind. They also have other benefits such as being more aware of mind or increasing interest in things. Some people find that their mood is improving and they start doing things they have stopped doing.

It may take a few months for the condition to improve or for the disease to slow down.

Side effects:

These medications can also have these side effects.

* Feeling nauseous

● Dysentery

* Loss of appetite

* Tension in the muscles

* Insomnia or excessive dreaming

These side effects can be alleviated to some extent by reducing the dose and then gradually increasing it, and not using it after meals. These effects usually begin to subside after a few weeks and disappear if the medication is stopped.

Further details can be obtained from the doctor or from the booklet in the packet.

How do these medicines work? :

 Acetylcholine is a chemical that acts as a messenger in the parts of the brain that are associated with memory. In Alzheimer's disease, the brain cells that are related to memory begin to die and the chemical is gradually depleted.

These drugs increase the amount of this chemical in the brain, which helps reduce the symptoms of the disease.

How effective are these medicines?

 About fifty to sixty percent of patients who use these drugs experience a slight reduction in symptoms over a six-month period or do not feel worse. But there is no consensus that these benefits are temporary or that these drugs work for a long time. If you do not feel well after the first few months, these medications should be stopped. The UK's National Institute of Clinical Excellence has ruled that these drugs are not as effective in the onset of Alzheimer's disease as they cost, and should only be given when the disease is moderate to severe. Although many people do not agree with this decision.

How to use the medicine:

These medications are started in small amounts and gradually increased according to the doctor's instructions. To get the most out of these medicines, it is important that they be used regularly. Don't worry if there are some painful effects in the beginning, these effects often subside over time and disappear in a few weeks.

How long should I take this medicine?

 These medications are initially given for three to four months. If they do not show any benefit in three or four months, they should be stopped on the advice of a doctor. If they seem to benefit, there is still no consensus on how long they should be given. A test for Alzheimer's disease is the Mini Mental State Examination. It is currently said that these drugs should be used only when Alzheimer's disease is of moderate severity, ie the score of this test is between ten and twenty. But there is some evidence that some patients benefit from mild to severe illness.

You may also have some blood tests and a brain scan before starting this medication to see if there is any other reason for your memory impairment to be altered by Alzheimer's disease.

(Memantine) Memantine

This medicine is being used to treat dementia in Germany. It affects the brain's chemical glutamate, which is used in memory and learning. In Alzheimer's disease, glutamate is released in large quantities from brain cells that break down, and this impairs memory. Research so far has shown that in more than half of the people who use the drug, the progression of dementia slows down somewhat, but the benefits are still greater. Seen in people with severe dementia. The painful effects of memantine, which are not very severe, include nausea, anxiety, abdominal pain and headaches.

More research is currently underway on memantine. According to guidelines issued by the National Institute of Clinical Excellence UK, memantine should not be given to ordinary patients in the UK as there are doubts about the extent to which it is beneficial.

Other treatment:

Gingko Biloba

It is a naturally occurring medicine derived from a tree called "Maiden Diamond". It has long been said that it improves memory. Some research suggests that it may be as beneficial in Alzheimer's disease as the medications mentioned above. It is thought to heal the body's naturally occurring toxins that come out of injured and dying cells. It may also improve blood flow to the brain.

It also has some side effects. It can block blood clotting so people with diseases that reduce blood clotting ability, or people taking blood thinners such as aspirin or warfarin should Medication should not be used.

The general idea is that more research is needed before regular use of this drug. This medicine can be taken with other medicines mentioned above. But it is important that you consult your doctor before starting it.

VITAMIN-E

It is also a naturally occurring medicine found in soybean oil, sunflower seeds, corn and cotton seeds, cereal or fish oil or nuts. Vitamin E has many benefits for the body and it also helps protect other cells from toxins released from injured and dying cells.

Some research shows that it can slow the progression of Alzheimer's disease. In the United States, this drug is used as a second-line drug after or with "choline estrogen inhibitors."

It also affects blood clotting. Therefore, it is important that patients who are taking blood thinners or have a blood clotting disorder should consult a doctor and take this medicine with caution. However, this medicine can be taken with aspirin.

A 2004 study found that daily consumption of more than 400 units could be harmful. Some experts say that the maximum daily intake should be 200 units.

Some experts also believe that long-term regular consumption of foods rich in this vitamin can help reduce the risk of the disease.

Selegeline

 This medicine is commonly used to treat Parkinson's disease. It is thought to protect other cells from toxins released from inactive and dying cells. But it has more side effects than vitamin E, such as lowering blood pressure, nausea, dizziness, excessive sleepiness, and so on.

Some research suggests that it may slow the progression of Alzheimer's disease, but more research is needed.

Alternative therapies:

Research on alternative therapies and medicines is ongoing. But it is important to beware of the baseless claims that appear in the newspapers every day. Be sure to consult your doctor before using any medicine.

The disease is a psychological and physical challenge for the patient's family. It is important for the family to take care of their health in order to fight this disease.