A risk-benefit assessment of tacrine in the treatment of Alzheimer's disease

被引:20
作者
Samuels, SC
Davis, KL
机构
[1] Department of Psychiatry, Mount Sinai Medical Center, New York, NY
[2] Department of Psychiatry, Mount Sinai Medical Center, Box 1230, New York, NY 10029, One Gustave Levy Place
关键词
D O I
10.2165/00002018-199716010-00005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Tacrine, the first drug specifically approved for Alzheimer's disease, produces symptomatic improvement. The theoretical rationale behind treating Alzheimer's disease with tacrine is based on central cholinergic depletion. Tacrine is centrally acting, uncompetitive reversible inhibitor of acetylcholinesterase and butyrylcholinesterase. Multiple clinical trials support the effectiveness of tacrine in Alzheimer's disease. High dosages of tacrine are required for efficacy, with the potential for hepatic and mild gastrointestinal adverse effects. However, the benefits of tacrine currently outweigh its risks, and a trial of the drug should be offered to patients. As clinical experience with tacrine increases, the long term risk-benefit equation may be refined.
引用
收藏
页码:66 / 77
页数:12
相关论文
共 55 条
[1]   PUTATIVE MECHANISMS OF ACTION OF TACRINE IN ALZHEIMERS-DISEASE [J].
ADEM, A .
ACTA NEUROLOGICA SCANDINAVICA, 1992, 85 :69-74
[2]  
ALHAINEN K, 1993, ACTA NEUROL SCAND, V88, P16
[3]   DISCRIMINATION OF TETRAHYDROAMINOACRIDINE RESPONDERS BY A SINGLE DOSE PHARMACO-EEG IN PATIENTS WITH ALZHEIMERS-DISEASE [J].
ALHAINEN, K ;
PARTANEN, J ;
REINIKAINEN, K ;
LAULUMAA, V ;
SOININEN, H ;
AIRAKSINEN, M ;
RIEKKINEN, P .
NEUROSCIENCE LETTERS, 1991, 127 (01) :113-116
[4]   HETEROGENEITY OF ADVERSE HEPATIC REACTIONS TO TETRAHYDROAMINOACRIDINE [J].
AMES, DJ ;
BHATHAL, PS ;
DAVIES, BM ;
FRASER, JRE ;
GIBSON, PR ;
ROBERTS, S .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 1990, 20 (02) :193-195
[5]  
AMES DJ, 1988, LANCET, V1, P887
[7]  
BIERER LM, 1995, J NEUROCHEM, V64, P749
[8]   TACRINE (TETRAHYDROAMINOACRIDINE - THA) AND LECITHIN IN SENILE DEMENTIA OF THE ALZHEIMER TYPE - A MULTICENTER TRIAL [J].
CHATELLIER, G ;
LACOMBLEZ, L .
BRITISH MEDICAL JOURNAL, 1990, 300 (6723) :495-499
[9]   GENE DOSE OF APOLIPOPROTEIN-E TYPE-4 ALLELE AND THE RISK OF ALZHEIMERS-DISEASE IN LATE-ONSET FAMILIES [J].
CORDER, EH ;
SAUNDERS, AM ;
STRITTMATTER, WJ ;
SCHMECHEL, DE ;
GASKELL, PC ;
SMALL, GW ;
ROSES, AD ;
HAINES, JL ;
PERICAKVANCE, MA .
SCIENCE, 1993, 261 (5123) :921-923
[10]  
CUTLER NR, 1990, PSYCHOPHARMACOL BULL, V26, P231