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Medications

The medications used in Alzheimer's disease have also been tried in MCI. Those that have worked the best so far are the cholinesterase inhibitors.

• Cholinesterase is an enzyme that breaks down a chemical in the brain called acetylcholine. Acetylcholine acts as an important messaging system in the brain, but it is impaired in many people with MCI.
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• Cholinesterase inhibitors stop the breakdown of this neurotransmitter. They increase the amount of acetylcholine in the brain and improve brain function in MCI.
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• These drugs may improve or stabilize cognitive functions. They also may have positive effects on behavior and everyday activities.
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• They are not a cure, but they may slow down conversion of MCI into dementia. In many people, the effect is fairly modest but definite. In others, these drugs do not have much of a noticeable effect.
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• The effects are temporary, since these drugs do not change the underlying cause of the MCI, which remains unknown.
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• Examples of cholinesterase inhibitors include donepezil (Aricept), rivastigmine (Exelon), and galantamine/galanthamine (Reminyl). These drugs have in effect replaced an older drug called tacrine (Cognex).