Cholinesterase Inhibitors and Their Impact on the Mentality and Physicality of Alzheimer’s Disease Patients

Abstract: The increasing prevalence of Alzheimer’s Disease (AD) among older adults makes it necessary to create public, comprehensive understandings of its management strategies. This literature review analyzes the role of cholinesterase inhibitors—including donepezil, galantamine, and rivastigmine—in slowing down the cognitive symptoms associated with AD, along with potential emotional side effects that may arise from these medications. Cholinesterase inhibitors are divided into two categories of inhibitors: acetylcholinesterase inhibitors and butyrylcholinesterase inhibitors. Acetylcholinesterase inhibitors block the breakdown of acetylcholine, a key neurotransmitter involved in memory and learning. Donepezil and galantamine fall under this category and are noted for their cognitive benefits. However, they may induce emotional instability, impacting both patients and caregivers. Butyrylcholinesterase inhibitors have been more recently discovered, and they play a role by inhibiting the activity of the enzyme, butyrylcholinesterase, from breaking down acetylcholine and butyrylcholine. Rivastigmine is both an acetylcholinesterase and butyrylcholinesterase inhibitor, offering a unique transdermal delivery option that may improve tolerability. By understanding the mechanisms, applications, and limitations of cholinesterase inhibitors, healthcare providers and patients can make more informed decisions regarding medication use and prescription for AD management, contributing more care and support for individuals affected by this disease.