Alzheimer's disease: Current treatment options and future developments

The incidence of Alzheimer's disease (AD) is expected to increase through the year 2050 with an estimated prevalence of 11 to 16 million cases. Two classes of medications are FDA approved for managing symptoms of AD, cholinesterase inhibitors (ChEls) and an N-methyl-D-aspartase (NMDA) receptor antagonist. ChEls are commonly used as initial treatment on diagnosis. Memantine, the only NMDA receptor antagonist, can be used as monotherapy as well as an adjuvant to ChEls. New doses and formulations of these medications have recently gained FDA approval. New compounds under development target the amyloid pathway, tau phosphorylation, or acetylcholine levels, and it is hoped that they will not only improve symptoms but also slow disease progression or even lead to a cure. (Formulary. 2011;46:268-284.)