Keeping up with the latest developments can be tricky. Here’s what we know today.
Symptom management is the key to living with Alzheimer’s, and pharmaceuticals can help. Research has shown that certain medications are more effective at earlier or later stages of dementia. According to the National Institute on Aging, medications work best on persons with early- to mid-stage dementia. To date, there has not been a published study that offers comparisons of these drugs. Therefore, there is no strong evidence that one medication is superior to another. That said, these medications reduce symptoms in a similar way and changing from one to another likely will not produce remarkably different outcomes.
Follow the links below to learn about prescription medications, supplements, and alternative therapies commonly used to treat dementia. The most commonly prescribed medications for improving cognition and slowing the progression of dementia are cholinesterase inhibitors and memantine.
Cholinesterase Inhibitors – Aricept®, Razadyne® (formerly Reminyl®), Exelon®
Cholinesterase inhibitors are commonly prescribed to individuals with Alzheimer’s disease and other forms of dementia in order to treat the symptoms of the disease. These types of medications may delay the progression of memory and language loss, as well as impaired judgment and thinking. More on Cholinesterase Inhibitors.
Memantine – Namenda®
Memantine, commonly prescribed in the United States under the brand name Namenda, is for people with moderate-to-severe Alzheimer’s disease and vascular dementia. Studies have shown memantine treats symptoms by improving memory, awareness, and concentration. More on Memantine – Namenda.
Namzaric® (Cholinesterase Inhibitor plus Memantine)
Depending on your loved one’s symptoms and stage of dementia, a doctor may prescribe both a cholinesterase inhibitor and memantine, or the drug Namzaric, which combines both in a single capsule taken once per day, providing the benefits of each, described above. Side effects of Namzaric include diarrhea, vomiting, and loss of appetite. Most Medicare Part D and Medicare Advantage plans cover the cost of Namzaric.
|Alzheimer’s and Dementia Medications Chart|
|Type of Medication||Brand Name||Generic Name||Stages of Alzheimer’s||Taken As||Side Effects||Medicare coverage?|
|Chlorinesterase inhibitor||Aricept||Donepezil||All stages||Pill||Nausea, diarrhea, loss of appetite||Yes|
|Chlorinesterase inhibitor||Razadyne||Galantamine||Early to mid||Pill or capsule||Nausea, diarrhea, loss of appetite||Yes|
|Chlorinesterase inhibitor||Exelon||Rivastigmine||All stages||Pill or skin patch||Nausea, diarrhea, loss of appetite||Yes|
|Memantine||Namenda||Menantine||Mid to late||Pill, capsule or solution||Headache, fatigue, constipation, dizziness||Yes|
|Memantine and Chlorinesterase inhibitor combined||Namzaric||Menantine + Donepezil||Mid to late||Capsule||Nausea, diarrhea, headache, dizziness||Yes|
CBD (aka Cannabidiol) is a compound derived from the Cannabis plant that has positive medicinal effects but does not make people feel “high,” or anxious. CBD, in various forms, is legal in 47 US States.
Studies have found evidence that cannabinoids such as CBD could help remove dementia from brain cells. However, the US Food and Drug Administration has not approved a CBD drug for treating dementia (though it has approved a CBD-based drug for treating epilepsy).
There are three ways CBD can work to improve health outcomes for persons with dementia: by reducing inflammation, by reducing oxygen buildup, and by working as a brain stimulant and neuroprotectant. From a user’s perspective, CBD may reduce stress and anxiety in the individual with dementia as well as reduce the decline of memory and other brain functions.
Individuals with dementia may also be prescribed medications that help deal with difficult behaviors and problems that arise as a result of the disease.
Anxiolytics: Medications used to treat anxiety
Dementia can be frightening and worrying process individuals as they lose abilities and independence. If the anxiety is mild, it can be managed without medication. For instance, relieving stress through exercise or meditation. However, more severe responses, such as panic attacks and emotional outbursts, may need to be treated with anxiolytics, medications that help calm and relax. More on Anxiolytics.
Antidepressants: Medications used to treat depression
Many individuals with dementia also experience depression. Loss of mobility, interactions with the world, and independence can escalate into loss of appetite, fatigue, and a lack of interest in daily activities. Antidepressants may help improve both mood and function for these people. More on Antidepressants.
Antipsychotics: Medications used to treat psychosis
As dementia progresses, the grasp on the difference between fact and fiction, and real and imagined, blurs. As this happens, people with dementia may have hallucinations or believe that other people are “out to get them.” Sometimes, the person may become agitated, uncooperative, or even hostile. Antipsychotics are prescribed in more serious cases to help manage difficult behaviors when anxiolytics (anti-anxiety medications) may not be enough. More on Antipsychotics.
Hypnotics: Medications used to promote sleeping
Individuals with dementia can also have difficulties getting to sleep or staying asleep. Many of the medications commonly prescribed to dementia patients can fatigue them during the day. This may make it harder for them to fall asleep or to sleep through the night. Some caregivers find it useful to limit the number of naps their loved ones take during the day. If increasing their daily activity does not help, hypnotics may help them find restful sleep. More on Hypnotics.
In addition to prescription medication, many individuals with dementia, including Alzheimer’s, use herbal medicine, supplemental nutrition, or other alternative therapies to help treat the disease’s progression and symptoms. Diet, physical activity, and mental activities may help slow the progression of the illness. More on alternative therapies. Even music has been shown to have a positive impact on some individuals. More about music and dementia.
In addition treatments already in use, there are new drugs and therapies in development for treating dementia.
Experimental drugs targeting plaque in the brain are showing benefits in animal tests and clinical trials. An anticoagulant (blood thinner) called 3K3A-APC that was being developed primarily for treating brain bleeds after strokes has also been shown to have dementia-fighting properties, reducing plaque in the brain during the early stages of dementia. BAN2401 is another drug that’s been effective on rats and is being put on clinical trial with adults. It also may alleviate plaque buildup in the brain. Both these drugs target amyloid-beta, and though amyloid-beta drugs have failed in the past at this stage, trials are ongoing and there is reason for hope.
Also on the horizon may be a drinkable cocktail that has been shown to repair brain cells and memory in animal tests by sabotaging the process by which amyloid-beta turns to plaque. Scientists discovered the key ingredient in a polymer that formed from decomposed antibiotics.
Experts have found a natural substance (bryostatin-1) in seaweed-like marine life could enable PKC-epsilon to reestablish broken links between brain cells. PKC-epsilon is a natural protein involved in connecting brain cells.
And there have been reports that drugs used to treat inflammation in the joints of people with arthritis have also alleviated symptoms of Alzheimer’s, which is partly caused by inflammation in the brain.
Other treatments in the trial phase include using ultrasound waves to safely penetrate the blood-brain barrier that helps brain cells fight infection, allowing for the clearing of plaques that cause Alzheimer’s. The waves can theoretically target precise parts of the brain without damaging surrounding areas, opening the barrier for treatments that previously could not get through. This would allow for better delivery of drugs, enhancing effectiveness and delivering improved outcomes.
You can read more about the general process of how clinical trials and studies work on the Clinical Studies page. For more specific information on clinical trials that are currently underway, the National Institute on Aging provides highlights of the 100+ current Alzheimer’s studies and has an Alzheimer’s Disease Clinical Trials Database where you can search for trials in your area or trials for a particular diagnosis or treatment. Also visit the Alzheimer’s Disease Cooperative Study’s website to learn about this organization’s work in collaboration with the National Institute on Aging to test new drugs to treat both the cognitive and behavioral symptoms of Alzheimer’s.