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Velnacrine is a small molecule acetylcholinesterase inhibitor and a hydroxylated derivative of tacrine. It was developed as a neuropsychiatric agent for the treatment of Alzheimer's disease. Velnacrine increases cholinergic neurotransmission by inhibiting acetylcholinesterase (AChE), thereby increasing levels of acetylcholine in the central nervous system. Clinical studies showed modest but significant cognitive benefits in Alzheimer's patients; however, its development was discontinued due to concerns about hepatotoxicity and other adverse effects[1][2][4][5].
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