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Combination Therapy for Alzheimer’s Disease

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Abstract

Alzheimer’s disease (AD) is a progressive, degenerative brain disease. The mainstay of current management of patients with AD involves drugs that provide symptomatic therapy. Two classes of medications have been approved by the US FDA for the treatment of AD: the cholinesterase inhibitors (ChEIs), which include galantamine and rivastigmine (both approved for use in mild to moderate AD) and donepezil (approved for use in mild to severe AD); and the non-competitive NMDA receptor antagonist memantine (approved for use in moderate to severe AD). The European and Asian regulatory bodies have also approved ChEIs as monotherapy in mild to moderate AD. Future research directions are mostly focusing on disease modification and prevention.

This review covers key studies of the efficacy, safety and tolerability of combination therapy in AD, defined as a combination of the NMDA receptor antagonist memantine with any of the ChEIs (donepezil, galantamine or rivastigmine) for the treatment of AD. Relevant studies were identified via a PubMed search. This review shows that combination therapy for AD seems to be safe, well tolerated and may represent the current gold standard for treatment of moderate to severe AD and possibly mild to moderate AD as well.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. Dr Grossberg has acted as a consultant for Accera, Baxter Bioscience, Bristol-Myers Squibb, Forest Laboratories, Novartis, Medivation and Pfizer; has received honoraria from Novartis; and has received research grants from Bristol-Myers Squibb, Forest Laboratories, Janssen, Myriad, Novartis and Pfizer. Dr Patel has no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Neurology and Psychiatry, St. Louis University School of Medicine, 1428 S Grand Blvd, St Louis, Missouri, 63104, USA

    Laxeshkumar Patel MD & George T. Grossberg

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  1. Laxeshkumar Patel MD
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  2. George T. Grossberg
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Correspondence to Laxeshkumar Patel MD.

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Patel, L., Grossberg, G.T. Combination Therapy for Alzheimer’s Disease. Drugs Aging 28, 539–546 (2011). https://doi.org/10.2165/11591860-000000000-00000

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