Cholinesterase inhibitors in dementias: An overview

Alzheimer’s dementia (AD) is quite complicated, and it is improbable that any one drug or other intervention will be able to successfully treat it. Current pharmacotherapeutic approaches work by regulating the levels of neurotransmitters in the brain, mainly acetylcholine and glutamate, and they are based on aiding the sufferers in preserving mental abilities, managing behavioral manifestations, and trying to delay the progression and slow down the appearance of symptoms of the disease. Although these approaches do not treat the underlying cause of the disease and they are not always useful for all subjects with AD, they are often efficacious in several outcomes (namely cognitive and behavioral symptoms and functional status) and well tolerated. Research is looking for other drugs able to modify the course of disease, trying to revisit the classical strategies and mixing them with new molecules from the perspective of the development of “multitarget-directed ligands, " with the aim of addressing several critical pathophysiological processes simultaneously.