“…However, the current use of anticholinesterase drugs to improve cholinergic function has not been fully effective for many patients, and debate continues about their costeffectiveness (AD2000 Collaborative Group, 2004). This is probably because Alzheimer disease typically involves the vast loss of synaptic contacts in cortex and elsewhere that normally release a number of brain neurotransmitter and neuropeptide systems including cholinergic, serotonergic, b-adrenergic, somatostatinergic, and GABAergic systems (Chen et al, 2000;Davis et al, 1999;Francis et al, 1999;Reinikainen et al, 1990), and this loss of multiple, often interacting systems may be important for the severe cognitive and behavioral impairments in Alzheimer patients. If true, optimal pharmacological treatment will require agents directed at a number of different systems in combination.…”