How do modern drugs work?
1. Memantine: the drug memantine can improve the exchange of signals between nerve cells in the brain.
The depositing of the harmful beta-amyloid on the nerve cells causes a sort of “background noise”. The signals transmitted by the glutamate messenger are drowned out and no longer “heard”. Due to the constant over-stimulation with “background noise”, the nerve cells eventually die.
Memantine suppresses the “background noise” caused by beta-amyloid. The “glutamate signals” are better heard again, and the nerve cells can “talk” and “work” together better once more. The over-stimulation of the nerve cells is reduced, the cells are spared.
2. Acetylcholinesterase inhibitors: these work in a different way to improve the exchange of signals between nerve cells in the brain.
More and more cells in the brain of Alzheimer patients die during the course of the disease. This results in a deficiency of the transmitter acetylcholine. The transmission of signals between the nerve cells becomes increasingly weak or is brought to a standstill.
The more nerve cells have already died, the lower is the amount of the transmitter acetylcholine that is still present. Acetylcholinesterase inhibitors now try to counteract the lack of transmitter with a trick. This trick protects the amount of acetylcholine still left and thus keeps it usable for longer. In this way, the nerve signals can be better transmitted again. The nerve cells can “speak” a little louder again and will be “heard” better by others.
Even small steps are a great success. It’s not always easy to detect whether a drug is working or not. After all, there is no comparison of what the state of the person affected would be without the drug. But even the longer retention of abilities to perform quite everyday things can greatly enhance life for patients and people close to them.
The aim of treatment for Alzheimer disease with the medical options available today, should be defined as follows: to relieve the symptoms and support and preserve the existing abilities for as long as possible. In this sense, it is hugely valuable if a drug can enable patients to cope for longer in their own surroundings and to manage such simple things as going to the toilet or daily personal hygiene without the aid of others. It can also be a great help for people living together if the affected persons are able to make themselves understood, if words are still present, or if one can communicate by gestures and facial expressions. The treatment will attempt to maintain these abilities for as long as possible. Thus, many of these seemingly minor things, can, in sum, make up the success of treatment. So also look out for initially unspectacular positive changes in everyday things. Indeed, even if the symptoms just don’t get any worse and remain constant at a certain level that is a success.
Talk about your observations regularly with the doctor, who is reliant on your information to assess how treatment is going.
If you can’t see any changes it might be worth to talk to the doctor about combining the available drugs. If you want to learn more about combination therapy, please click here .