Treatment of Alzheimers Disease - Literature review Example

Treatment of Alzheimer’s Disease Treatment of Alzheimer’s Introduction Alzheimer Disease(ADI) is a condition and a type of dementia that results in the loss of memory, which affects thinking and behavioral patterns of individuals. One of the frightening features of this disease is that it develops very gradually and without treatment, it may get worst affecting daily activities. Due to the severity of its nature, treatment of this disease is much needed. Thus, medical researchers and practitioners are adapting to various treatment methods to make them more effective and to prevent the disease from progressing to the worst stages. This report provides critical analysis of six peer reviewed articles that provide an insight on medical treatment of Alzheimer’s disease. According to Salomone et al. (2012), the current treatment of this disease consists of cholinesterase inhibitors (donepezil, rivastigmine galantamine). Though, these drugs are playing an effective role in providing relief to the symptoms and the indications of the disease but they do not stop the disease from progressing to later stages. This is the reason why current researchers are more focused on drugs discovery, finding new means in order to control the disease during its onset before it starts progressing to the worst stages. In Alzheimer’s, an early treatment will give better results. However, this idea that early detection and its treatment would be successful is still naïve and under scrutiny as it is difficult for bio-makers to actually detect the changes taking place in the brain relating to dysfunction and disarray. A range of drugs is used to reduce β-amyloid (Aβ) but they are still short term. Hence, need of profound research clinical diagnosis is required that focuses on understanding the effect of Alzheimer disease pathophysiology and on future drug development (Salomone et al., 2012). Though the current researches provide an analysis of various treatments of Alzheimer’s disease which eases the progressiveness of the disease but there is no inevitable preventing methodology that may affect the brain’s pathological function like senile plaques and neurofibrillary tangles. As these areas are affected the most, it is necessary that more research is conducted that reduces the underlying effect. As β-amyloid (Aβ) peptides are playing the most crucial role in the development of AD but as mentioned before, though there is no treatment to stop their progressive nature but practitioners have identified drugs that can intervene with Aβ formation for instance α-secretase, which is an enzyme having the responsibility for non-amyloidogenic metabolism of APP, they are being developed and EHT-0202 has also been a part of the study that if it is used, can reduce the activities of β-amyloid (Aβ) peptides. Moreover, there was a discovery of β-secretase (memapsin-2, β-amyloid cleaving enzyme-1 [BACE-1]) which is also an enzyme that may have a role in regulating amyloidogenic APP metabolism. There are studies being conducted but due to chemical issues, very few compounds are now being studied in clinical testing like (CTS_21166), γ-secretase modulators. The purpose of the study of these compounds is to reduce the rate of AD in patients so that the disease fully eradicates in the coming years (Panza et al., 2009). This study provides a positive approach towards treatment of AD, but in the practical sense it is difficult to test compounds and scholars do face many disappointments when the findings indicate that certain compounds cannot be approached for clinical testing. Drugs like Cholinesterase Inhibitors (ChEIs) are widely used and marketed for the cure of Alzheimer’s but still there have been some discrepancies in finding quantified controlled groups that can effectively manage these drugs in terms of safety. For this purpose, Dr. Krista has worked to summarize the data for the effective use of the clinicians. This work was done by performing a meta-analysis of these ChEIs (donepezil, rivastigmine and galantimine) and getting the feedback from pharmaceutical companies regarding the adverse effects if they were reported of any in the case when the treatment was discontinued for some reason. The results of this research showed the impact of ChEIs was varied on different people. About 5159 patients had treatment through ChEIs and some people received placebo. It was observed that the people who had ChEIs had more cases of adverse effects whereas the individuals receiving placebo had less adverse effects. Even though, the interpretation of this study was that patients who were treated more with ChEIs had more adverse effects and due to this reason they discontinued their treatment, but this also provides an understanding that this was the only treatment most individuals opted for, as it reduced the complexity of the disease (Lanctôt et al., 2003). This research that people are only using ChEIs medications is not enough. It is a well-established fact that it has been just 15 years of discovery of Alzheimer’s so it is necessary that the treatment is marketed more proactively besides just ChEIs and also more relevant research is needed. It is investigated as new and appropriate measures for treatment of this disease so that the person who is affected can resume his normal life and is fully cured of the disease. Alzheimer’s disease comprises of neuropsychiatric symptoms that aggregates abnormal behavioral tendencies. The treatment provided through ChEIs reduces its impact but few reports have emerged that provide an analysis of its affect. Research was conducted through clinical trials and measuring behavioral outcomes in the individuals who were taking the drug. Results showed that the most common adverse effect of this drug ChEIs were mood swings, lethargy and apathy. The patients having severe dementia with their Alzheimers in the late stage had more adverse effect of the drugs. The most surprising element was that the patients who were using a placebo had lesser impact even though the number of people who were using placebo was far less. A drug memantine if taken provides relief to irritability and discomfort (Cummings et al., 2008). Hence, after examining the article by Cummings et al. (2008), it can be deduced that even though there are anti-dementia agents that are providing benefits in Alzheimers but there are few negative outcomes that need to be focused and identified in order to reduce its adverse effect. Besides ChEis, the patients should utilize other nutriment products like Caprylic acid and coconut oil and try to use foods that contain Omega-3 fatty acids. These alternatives are more beneficial to treat Alzheimers and reduce the underlying effect of drugs. A research article by Dorothy P. Rice reviewed peer reviewed journals related to the costs of treatment of Alzheimer’s indicated that there is a rise in Alzheimer’s cases seen and it is necessary to identify strategies to manage this population through Management Dementia Organizations. The results generated by the author depicted that Alzheimer’s disease (AD) is present more in people aged 65 and older, which comes about 5.7% and there are only about 0.55% of these people in managed care category and this is a small number. A cost of formal care comes about $27,672 per patient on a yearly basis. As far as treatment is concerned, it is seen that Donepezil treatment has been very effective especially is there is early detection it reduces the decline of cognitive ability in individuals. The main cause of concern of this study was the costs of treatment of Alzheimer’s Diseases and Management Care Organizations, which is costly and it would be difficult to curtail the cost associated with it in the future (Rice et al., 2001). Even though, the implications of this study provide an understanding that these costs will always prevail but it is also necessary to comprehend that there are different sources of the costs depending on the nursing homes and resource utilization which are needed to be considered in order to generate a positive implication for much needed researches for future specially as far as treatment of Alzheimer is concerned. Another article by Schneider et al. (2006) provides insight on using antipsychotic medicines for the treatment of Alzheimer’s and other dementia taking into consideration of their adverse effects like increase in decline rate of mental and cognitive ability as well as risk of mortality. Observations were carried out in 421 out patients of Alzheimer’s disease and they were given olanzapine, risperidone or any placebo. Doses were adjusted and effect of their treatment was monitored. As a result, there were significant differences seen in about 32 patients who were given quetiapine, risperidone and placebo indicating that there were some disadvantages of using anti psychological drugs. The patients had increased aggression, agitation and apathy (Schneider et al., 2006). Even though these findings suggest that most of the medications have a very negative impact on individuals but still in smaller quantities no major affect was seen on individuals. Conclusion After critically evaluating all the six articles, it can be concluded that there is much needed research needed for the treatment of AD. Research indicates that the treatment through ChEIs and other medications show improvement, but there is no preventative method, which can fully eliminate disease. Alzheimer’s is a progressive disease and in order to preclude it from occurring an individual requires having a good diet, with no high blood pressure or heart disease and also requires intake of high levels of vitamin folate. Absence of these may increase the risk of AD. Hence, good physical, social and mental activities are a preventative measure, which should be carried by all individuals and more research is required to prevent the disease from progressing. List of References Cummings, J., Mackell, J. & Kaufer, D., 2008. Behavioral effects of current Alzheimer’s disease treatments: A descriptive review. The Journal of the Alzheimers Association, 4(1), pp.49-60. Lanctôt, K.L. et al., 2003. Efficacy and safety of cholinesterase inhibitors in Alzheimers disease: a meta-analysis. CMAJ , 169(6), pp.557-64. Panza, F. et al., 2009. Disease-Modifying Approach to the Treatment of Alzheimer’s Disease. Drugs & Aging, 26(7), pp. 537-555. Rice, D. et al., 2001. Prevalence, costs, and treatment of Alzheimers disease and related dementia: a managed care perspective. Am J Manag Care, 7(8), pp.809-8018. Salomone, S. et al., 2012. New pharmacological strategies for treatment of Alzheimers disease: focus on disease modifying drugs. British Journal of Clinical Pharmacology, 73(4), pp.504–17. Schneider, L.S. et al., 2006. Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimers Disease. N Engl J Med 2006, 355(1), pp.1525-38. Read More