Pharmacological treatment strategies in dementia disorders

Pharmacological treatment strategies in dementia disorders concern the use of vasodilators, nootropics, psychostimulants, acetylcholinergic drugs, monoaminergic drugs, and neuropeptides. The substitution of essential nutrients and the use of gangliosides and phosphatidylserine may also be considered. On the whole, drugs with vasodilator effects were unsuccessful in the past. However, new drugs have been introduced which also enhance the metabolism in the neurons. These drugs, the nootropics, often combine a vasodilator effect with the activation of brain metabolism and the protection of the brain from toxic effects. The effect of nootropics has mainly been demonstrated in animal experiments, whereas the drugs have been less effective in the treatment of demented patients. The use of psychostimulants should be tested carefully before ruling out their potential benefit. Acetylcholinergic drugs have attracted great interest in dementia treatment but, altogether, trails with these drugs have shown disappointing results. This may be due to the drugs not being effective enough, and therefore continued trials with this type of drug are necessary.