[Should Alzheimer disease be treated with tacrine? Review of the literature]

The authors describe the rationale for use of the acetylcholinesterase inhibitor, tacrine, in Alzheimer's disease and critically review the controlled clinical trials using this drug. The data shows that tacrine improves cognition and function, and that 20-40% of the patients may benefit from such treatment. A large proportion of the patients do not tolerate the highest dose, mainly because of an increase in serum liver-enzymes, which is reversible and asymptomatic. The authors recommend that tacrine should be considered for patients with Alzheimer's disease of mild and moderate severity, and present guidelines for clinical use.