Cholinergic Drugs in Alzheimer's Disease

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Abstract
Less than a decade ago, vasodilators and metabolic enhancers were the agents used to "treat" Alzheimer's disease, although it is primarily a disease neither of cerebral blood flow nor of altered metabolic activity. Once the importance of a cholinergic deficit in Alzheimer's disease had been elaborated,1 it became possible to conceive of a rational approach to treatment.There are three basic pharmacologic strategies for augmenting cholinergic neurotransmission: drugs can increase the synthesis or release of acetylcholine, protect acetylcholine from being degraded, or act directly at the cholinergic receptor. With a few exceptions, cholinomimetic compounds that unequivocably increase central cholinergic activity . . .