- The primary pharmacological treatments for Alzheimer's disease target the cholinergic neurotransmitter pathway.
- This is because Alzheimer's disease is characterized by a significant loss of cholinergic neurons in the brain, particularly in regions such as the hippocampus and cerebral cortex, which are critical for memory and cognitive functions.

- Most approved medications, such as acetylcholinesterase inhibitors (e.g., donepezil, rivastigmine, galantamine), work by inhibiting the enzyme acetylcholinesterase, which breaks down acetylcholine.
- This results in increased levels of acetylcholine in the synaptic cleft, thereby enhancing cholinergic transmission and temporarily improving cognitive symptoms.

- In contrast, other neurotransmitter systems like dopaminergic (important in Parkinson's disease), GABAergic, and serotonergic pathways are not the primary targets in Alzheimer's treatment, though they may play secondary roles in neuropsychiatric symptoms.

Reference: Adams and Victor's Principles of Neurology, 11th Edition, Chapter 39, page 1030