How do cholinesterase inhibitors help treat Alzheimer's disease?

David A. Merrill, MD
If you have been diagnosed with Alzheimer's disease, you may be advised to take a cholinesterase inhibitor. Cholinesterase inhibitors work by preserving the intactness of acetylcholine, which is one of the neurotransmitters that allow brain cells to communicate with each other.

Cholinesterase inhibitors are medications that support the function of cholinergic neurons. They may help with attention and memory, and may delay placement into a nursing home. The generic names for these drugs are donepezil, galantamine and rivastigmine. You can discuss with your doctor whether this is an option.
David B. Reuben, MD
Geriatric Medicine
Cholinesterase inhibitors can slow the progression of dementia. About 10-25% of people with dementia improve on this type of drug, and about 25% tend to get no benefit. There’s also evidence that some of the behavioral symptoms of dementia, such as agitation and psychotic symptoms, may be improved with cholinesterase inhibitors.
Donepezil, rivastigmine, galantamine, and tacrine belong to a class of drugs used to treat Alzheimer's disease called cholinesterase inhibitors. They raise the levels of acetylcholine in the brain, because a deficiency in this neurotransmitter contributes to the memory problems of Alzheimer's disease. They seem to work by blocking an enzyme that destroys acetylcholine, which presumably makes more acetylcholine available for transmitting impulses from one brain cell to another. The drugs are effective for people with mild to moderate Alzheimer's disease. Tacrine is rarely used because it's been associated with severe liver problems.

Only about 30% to 50% of the people who take this class of drugs show benefits. These medications may temporarily stabilize or improve memory problems and other cognitive symptoms. For example, one study found that taking donepezil for at least nine months postponed a patient's need to move to a nursing home by about 21 months.

Continue Learning about Central Nervous System Agent

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.