[Newly approved drugs for Alzheimer disease: effectiveness and limitation]

In addition to donepezil, 2 other cholinesterase inhibitors galantamine and rivastigmine, and an N-methyl-D-aspartic acid receptor antagonist, memantine, have been recently approved for the treatment of Alzheimer disease patients at mild to moderately severe and moderately severe to severe stages of the disease, respectively, in Japan. These drugs were approved about a decade ago in Europe, US, and some other countries in Asia, and have been widely used since then. Many studies have been performed to evaluate the clinical effectiveness and cost-effectiveness of these drugs for treating cognitive decline, deterioration of activity of daily living and behavior and mood disorders. Several systematic reviews of previous investigations of the effectiveness of these drugs suggest modest overall benefits for stabilizing and slowing decline in cognition and for reducing behavioral and psychological symptoms. Although these drugs may modulate various neurobiological aspects of Alzheimer disease and afford neuroprotection, in addition to improvement of impaired neurotransmission, limited evidence is available for the ability of these drugs to prevent or reverse the progression of the disease through disease-modifying action. In this article, we describe drugs profiles of the currently approved drugs for Alzheimer disease and discuss the effectiveness and limitations of these drugs.