Prescribing drugs for Alzheimer's disease in primary care: managing cognitive symptoms

There are currently no interventions that cure or even alter the progressive course of dementia. In the UK, donepezil, galantamine and rivastigmine are licensed for symptomatic treatment of mild to moderate Alzheimer's disease, and memantine is licensed for use in moderate to severe Alzheimer's disease.1-4 These drugs improve cognitive function by a modest amount compared with placebo.5 Although the National Institute for Health and Care Excellence (NICE) stipulates that such treatment should be initiated by a specialist, in many parts of the UK responsibility for continued prescription of these drugs is being transferred to primary care. Here we review the evidence for drugs prescribed for cognitive symptoms in Alzheimer's disease and highlight key issues for those who are prescribing them.