期刊
NEURODEGENERATIVE DISEASES
卷 15, 期 3, 页码 157-161出版社
KARGER
DOI: 10.1159/000381513
关键词
Neurocognitive disorders; Serum anticholinergic activity; Acetylcholine; Cholinesterase inhibitor; N-methyl-D-aspartate receptor antagonist
资金
- Eisai Co. Ltd.
- Daiichi Sankyo Inc.
- Ono Pharmaceutical Co. Ltd
We previously proposed the hypothesis of endogenous anticholinergic activity (AA) in Alzheimer's disease (AD). According to this hypothesis, the downregulation of acetylcholine seen in AD is associated with upregulation/hyperactivity of N-methyl-D-aspartate receptor (NMDAR). The hyperactivation of NMDAR then induces inflammation, which, in turn, causes AA to appear endogenously. Based on this hypothesis, we commented that cholinesterase inhibitors (ChEls) are 'preventative' therapy for AD and NMDAR antagonists are the true 'treatment' for AD. We also noted that ChEls, such as donepezil, could treat delirium. Moreover, we proposed measuring serum anticholinergic activity in patients, particularly AD patients, in out-of-hospital pharmacies to monitor the anticholinergic burden for targeted treatment. (C) 2015 S. Karger AG, Basel
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