Pharmacotherapy in Alzheimer’s disease and other dementias in practical settings: which drug, when and for whom?
1 Oddział Psychogeriatrii, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi
2 Zakład Psychologii Lekarskiej, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Łodzi
Adres do korespondencji: Dr n. med. Marcin Wojtera, Oddział Psychogeriatrii, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi, ul. Czechosłowacka 8/10, 92-216 Łódź, e-mail: mwojtera@medycynamilorzab.pl
Aktualn Neurol 2014, 14 (4), p. 218–227
DOI: 10.15557/AN.2014.0025
ABSTRACT

Dementia is characterised by a combination of different types of cognitive impairment, which is so significant that it affects daily living, disrupts patients’ professional activity and leads to complete dependence on relatives or adequate institutions. Dementias are usually caused by neurodegenerative processes or damage of vascular origin within the central nervous system. Alzheimer’s disease, which is fatal and progressive, is the main cause of dementia. Drugs used in modern medicine have only symptomatic effects and have no influence on the cause of the illness. Drugs registered for Alzheimer’s disease treatment (cholinesterase inhibitors and memantine) have been available for many years. The majority of doctors involved in treating dementia believe that they are well acquainted with the above substances which they often use. In clinical trials, it has been proven that the drugs have a moderate influence on cognitive functions, behavioural and psychological symptoms of dementia, and on activities of daily living. The influence of the drugs on the natural course of the disease in the central nervous system is still a controversial issue. This article discusses the clinical use of anti-dementia drugs available in Poland and practical recommendations regarding their choice in daily practice. Moreover, current recommendations for a change of the therapy (to a different inhibitor), combination therapy (cholinesterase inhibitors and memantine) and necessary safety procedures (contraindications, interactions) are presented.

Keywords: Alzheimer’s disease, cholinesterase inhibitors, memantine, treatment, dementia