Tacrine is not licenced in the UK but has been used in the US for the treatment of cognitive deficits of Alzheimer's disease. Its use is limited by a significant incidence of hepatotoxicity and mild cognitive benefits. It has been stated that tacrine does not alter the course of the disease (1).
Tacrine is a centrally active non-competitive reversible acetylcholinesterase inhibitor. The rationale for using a drug such as tacrine is that neurones that release acetylcholine are especially affected in Alzheimer's. There is correlation between the degree of cholinergic involvement and neuropathological variables such as plaque count and with the degree of dementia.
Tacrine is no longer prescribed due to a relatively unfavorable administration schedule (4 times daily) and side-effect profile (potential hepatotoxicity) (2).
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