Review: Pharmacological Approaches to Cognitive Impairment in Brain Disorders and Injury

Cognitive impairment resulting from brain disease and injury significantly affects patients’ quality of life by impairing memory, language, and other cognitive functions. The primary causes include dementia, mild cognitive impairment (MCI), and delirium, as well as cognitive deficits associated with chemotherapy and neurodegenerative diseases like Huntington’s disease and multiple sclerosis. Pharmacological interventions play a crucial role in managing these impairments. Cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and NMDA receptor antagonists (memantine) are widely used for dementia. Antipsychotics (e.g., haloperidol, clozapine, risperidone) target dopamine receptors to treat cognitive dysfunction in delirium and schizophrenia. Nootropics enhance cognitive performance, while calcium channel blockers (nimodipine, nilvadipine) prevent neurodegeneration by reducing calcium overload. Cognitive enhancers like erythropoietin, SSRIs (fluoxetine), modafinil, and methylphenidate have shown promise in mitigating chemotherapy-induced cognitive decline. A multifaceted pharmacological strategy tailored to the underlying pathology offers potential to improve cognitive outcomes in affected patients.