The treatment of Alzheimer's disease (AD) can be roughly divided into Disease-modifying Drugs (DMD) and Symptomatic Drugs (SD). Major strategies of DMD are the amyloid vaccine therapy and β/γ-secretase inhibitors, which have been developed with high expectations as fundamental treatments for AD. As SD, donepezil, galantamine, rivastigmine, and memantine are now usable. While memantine is an NMDA receptor inhibitor, the remaining three agents are cholinesterase inhibitors. The inhibitory mechanisms of the four agents exhibit some differences. Although they may offer tips for proper use, the SD guidelines have so far stated that there are no significant differences among SD. The guidelines also state that no SD can stop the progression of AD and that their use for MCI should not be encouraged.
 There are some criticisms about the use of SD because they are not root treatments. In contrast, there are some reports that SD delay AD progression, preserve ADL, reduce the care burden and have an effect on BPSD. Therefore, in proper combination with non-drug treatments, the use of SD is considered to be valuable.
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