At the moment, we have five formally approved anti-dementia drugs. It is well known that abnormalities in cholinergic neurons are prominent among the pathological changes in the brains of patients with Alzheimer’s disease (AD) and that the impact of these abnormalities can be reduced by inhibiting the enzymatic breakdown of acetylcholine using cholinesterase inhibitors. Glutamate is the main excitatory neurotransmitter in the central nervous system, implicated in neural transmission, learning, memory and neural plasticity, and the enhancement of the excitatory action of glutamate may play a role in the pathogenesis of AD. Memantine may prevent excitatory amino acid neurotoxicity without interfering with the actions of glutamate that are necessary for learning and memory. However, these symptomatic treatments offer only modest benefits and disease-modifying therapies are still in development stage. Unfortunately, many other drugs with potential anti-pathogenic effects have not shown significant clinical benefits. In mild cognitive impairment, consistent results were not obtained. Then, although exists many pathogenic hypothesis in AD the current and associate available drugs does not change the natural progression of the disease.