DRUGS

I. Cholinesterase inhibitors and Memantine

●Donepezil (Aricept) ○ All stages of AD

● Rivastigmine (Exelon) patch indicated to all stages of AD

● Galantamine (Razadyne)

● Tacrine (Cognex) → No longer used (Hepatotoxicity)

- 1st AChEI in the market

First line therapy in early management of behavioral symptoms.

Il. Antipsychotics

• Haloperidol

• Olanzapine (Olavex)

• Quetiapine (seroquel)

• Risperidone (Aspidon)

• Ziprasidone (Geodon)

Target symptoms

Psychosis: hallucinations, delusions, suspiciousness

Disruptive behaviors: agitation, aggresion

III. Antidepressants

• Citalopram (Celexa)

• Escitalopram (Cipralex)

• Fluoxetine (Prozac)

• Paroxetine (paxil)

• Sertraline

• Venlafaxine

• Trazodone Desyrel

Target symptoms

Depression: poor appetite. insomnia, hopelessness, anhedonia, withdrawal, suicidal thoughts, agitation, aniety

ANTICONVULSANTS

• Carbamazepin e (Tegretol)

• Valproic acid

• Oxazepam

Target symptoms: Agitation or aggression

Lecanemab-Irmb

● Humanized IgG1 monoclonal antibody that binds with high affinity to Aβ

● IV

● S/E: headaches and infusion-related reactions (nausea, changes in blood pressure, flu-like symptoms)

Aducanumab

● -mab = monoclonal antibody

● For MILD AD

● First FDA-approved therapy to address the underlying biology of Alzheimer’s disease

● Reduces amyloid plaques

● Initiated in patients with mild cognitive impairment (MCI) or mild dementia stage of disease

. Donanemab.

• Disease-modifying immunotherapy.

• Treats mild

• cognitive impairment or mild Alzheimer's by removing abnormal beta-amyloid to help reduce the number of plaques in the brain.

• side effects include brain swelling and bleeding, headache, confusion, dizziness, vision changes, nausea, seizures, and difficulty walking.