Alzheimer’s disease (AD) is the most common cause of dementia and is a progressive neurodegenerative illness for which at present there is no cure. The management involves both nonpharmacological and pharmacological approaches. This submission will concentrate mostly on the acetylcholinesterase inhibitors (AChEI), donepezil, rivastigmine and galantamine as well as the NMDA receptor antagonist m...

Approximately, two-thirds patients with Alzheimer’s disease (AD) are reported to have homozygous wild-type butyrylcholinesterase (BuChE) gene expression. It is associated with a higher rate of hydrolysis of acetylcholine, which ultimately leads to increase in the levels of BuChE in advanced stages of the disease. Rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and BuChE, might be ...

AIM To investigate whether 1-step titration of the rivastigmine patch (initiated at 5 cm(2) and titrated to 10 cm(2) after 4 weeks) is well tolerated in Japanese patients with Alzheimer's disease (AD) as compared to 3-step titration (initiated at 2.5 cm(2) and titrated by 2.5 cm(2) every 4 weeks to 10 cm(2)). METHODS A 24-week, multicenter, randomized, double-blind study was conducted in Japa...

To the Editor: Cholinesterase inhibitors are widely accepted as established therapeutic intervention across the entire severity spectrum of Alzheimer’s disease. However, fear of increased corrected QT interval (QTc) time is one of the main reasons for nonprescription of cholinergic drugs.1 While it is generally accepted that therapeutic efficacy of cholinergic therapy is dose dependent, a large...

During the past decade, transdermal delivery systems (TDS) have become increasingly important for treating neurologic and psychiatric disorders. The rivastigmine patch was the first patch to be approved to treat Alzheimer's disease (AD). The 9.5 mg/24 h patch has equal efficacy to the capsules and reduces gastrointestinal adverse events, such as nausea and vomiting, by two-thirds. This treatmen...

The role of the functional architecture of the HuAChE (human acetylcholinesterase) in reactivity toward the carbamates pyridostigmine, rivastigmine and several analogues of physostigmine, that are currently used or considered for use as drugs for Alzheimer's disease, was analysed using over 20 mutants of residues that constitute the interaction subsites in the active centre. Both steps of the H...