Rational Choices

Enhancing cholinergic transmission using cholinergic compounds may be one of the most effective ways of treating, and possibly preventing, memory loss. Donepezil (Aricept) heads my recommended list, but high cost and the fact that it is a prescription medication are significant limitations. Exelon and Remmyl are alternatives to Aricept, but they are also expensive prescription medications. If you would like to try other options, particularly if you prefer natural substances that you can obtain in health food stores, you can consider acetyl-l-carnitine or lecithin. But I'd like you to remember that the data on these other medications are not as convincing as they are for Aricept (or Exelon or Reminyl). Regardless of which agent you choose, the standard approach is to start at the lowest dose and increase it gradually until you reach the maximum dose that you can tolerate without side effects. Do not take more than one of these medications simultaneously, because the risk of toxicity increases.

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