When Aricept (donepezil) was first approved by the FDA in 1996 for the treatment of Alzheimer’s Dementia (AD), there was an almost euphoric sense that we were finally beginning to make progress in treating a previously untreatable disease.

In 2003, the FDA approved Namenda (memantine) as a treatment for moderate to severe Alzheimer’s Dementia (AD). Backed by the legendary marketing expertise of Forest Labs, the medication has become remarkably popular, gradually eating into the market share of the cholinesterase inhibitors (CIs). The question, as always, is whether this popularity is justified by the data.

The U.S. Food and Drug Administration (FDA) has ordered manufacturers of atypical – or secondgeneration- antipsychotic medications – to add a new black-box warning to the drugs’ labels telling prescribers and patients that the drugs are associated with an increased risk of death when used to treat psychosis and behavioral problems in elderly patients with dementia.

TCR: Welcome back to The Carlat Report, Dr. Agronin. You were our expert in October of 2003 when we discussed the diagnosis of dementia, and I understand that since then you have been busy with a new textbook project.

As longtime TCR readers with good memories know, Alois Alzheimer (1864-1915) was a German neurohistologist who, in 1906, reported the phenomenon of plaques and tangles in the brain of a 51 year-old woman who had died after five years of progressive dementia (TCR October 2003).