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While there is currently no cure for Alzheimer’s disease, certain medications may help manage symptoms or slow down disease progression. This is meant to provide a high-level overview of symptom management medications. We will discuss disease-modifying medications in the coming weeks.
As the name suggests, medications that address symptoms do not alter the underlying causes of disease or change its progression. Rather, they treat the symptoms associated with Alzheimer’s disease to support a better quality of life.
As Alzheimer’s disease progresses, brain cells are damaged and lost, disrupting communication between nerve cells. This worsens cognitive symptoms like memory loss and a decrease in executive functioning. Symptom‑based medications help remaining brain cells communicate more effectively for as long as possible. This is not a perfect fix; brain cells will continue to die while taking these medications, but they can improve the quality of life of the person living with the diagnosis.
Cholinesterase Inhibitors
Cholinesterase inhibitors treat symptoms of memory loss, thinking, language, and judgment. They work by preventing the breakdown of a chemical called acetylcholine. These medications may modestly improve cognition and daily functioning, and in some individuals may reduce fluctuations or hallucinations. Some common forms of cholinesterase inhibitors are:
- Donepezil, also known as Aricept.
- Galantamine, or Rimanyl/Razadyne.
- Rivastigmine, also known as Exelon.
It is crucial to talk with your doctor before taking any of these medications. Working with your doctor can help manage doses to mitigate side effects.
Anti Depressants (SSRI)
A diagnosis of Alzheimer’s can cause significant changes in a person’s social and personal life, which can lead to depression and anxiety in those living with the disease. Depression and anxiety can worsen attention, memory, and overall cognitive function.
Depression and anxiety are thought to be caused by a lack of serotonin in the brain. Serotonin is a neurotransmitter; it transfers messages between nerve cells. SSRIs, or selective serotonin reuptake inhibitors, increase the brain’s serotonin levels to facilitate communication between cells. Antidepressants may help improve symptoms such as depression, anxiety, irritability, and, in some cases, apathy or disinhibition.
Some common antidepressants prescribed to those living with dementia include:
- Escitalopram
- Sertraline
- Fluoxetine
If you think any of these medications may be valuable to you or your loved one, please contact your primary care physician.
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@jlharsh H started namenda after his 2nd visit to his first neurologist. I never had much faith in that Dr. H got into the A/D program at UCLA and I am so pleased and grateful. His new neurologist there took him off of it because even though he doesn’t have a solid diagnosis, it is not Alzheimer’s, it might be vascular with some frontal lobe action. He had irritation, constipation, dizziness, loss of balance, fogginess & heightened confusion. He says he feels a world of difference and I can actually tell a difference in him, as well. He has been off of it a little over 60 days. The difference was slow until there was suddenly a wow. I can’t say exactly what the timing was.
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4 Reactions@dlssell Please let me know what your doctor says. Like you, I certainly don’t want my husband drugged to the point he doesn’t know what’s what, I would just love for him to live free of fear and without the agitation and restlessness. If my husband could just be happy and content without the meds that would be good for both of us.
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2 Reactions@jlharsh I have to add something important that I didn’t think to mention about H. We took a couple of road trips while he was on namenda and it was so unpleasant for both os us because he constantly thought we were gong to crash and we fought over it. We went on a road trip this past weekend and he was completely fine; calm, subdued and not the least bit on edge. He brought it up more than once that he felt so safe riding in the car this time over the namenda laden trips. That stuff (namenda) is not for everyone and needs to be vetted individually and carefully watched. We were trusting when we were greener and so lost and naive. Be careful.
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5 Reactions@labrown Dr and our family have felt this medication is not helping so in a plan of weening which stops today. The manic episodes could possibly be removing an antidepressant and the memantine. He now is going through periods of weeping and I’m able to work through the aggressive episodes…they do not seem to be manic since cutting back,on memantine…perhaps he just cannot tolerate these meds…so a slight improvement but still experiencing side affects of coming off these meds…I do have a sedative medication if necessary and don’t expect to have to administer unless absolutely have to. I hope this helps.
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6 Reactions@lkbous wonderful news…I’m hoping for the wow moment as well…
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3 Reactions@jlharsh
Hello, I was only recently diagnosed with Alzheimer's and am experiencing major upset and panic. I have been attributing my forgetfulness and brain fog to chronic stress and lack of sleep for the past year and a half. I hoped that if I could manage the stress things would improve.... anyway, finally saw a neurologist and blood test of ABETA 42, 40 and PTA 217 resulted in highly likely amyloid buildup. Am reading as much as I find on treatment, medications, etc. I have to find a neurologist who specializes in dementia. I take a blood thinner so some of the medications would not be suitable. They all sound awful as far as side effects. I have been member and get Daily Digest daily for a few years , just added this group to follow. I hope it remains active. One group that I followed for over two years just faded away and I miss those communications a great deal.
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4 ReactionsHi @alju My heart is hurting for yours as I let your words soak in. You have been facing scary symptoms for quite a while and I imagine finding out something concrete is hard to process.
I am tagging @japlok who may have helpful information to share. He created a discussion where you can review what he and others have been discussing about doctors and treatments…
-Mayo Clinic Discussion: Alzheimers care and treatments: Consult with Mayo Clinic?
https://connect.mayoclinic.org/discussion/alzheimers-care-treatments/
You mention likely amyloid buildup. Exactly what have you been told, and what is next? Do you have someone, family or friend you can process with?
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1 Reaction@jlharsh
@jlharIh
I haven't been told very much. The doctor who ordered the blood tests that I saw one time and who is not right for me suggested a medication Donepezil . I read the side effects of that and also of a couple of others and they are scary. I am trying to find another doctor and hope it doesn't take too long. Unfortunately, my family is very small, consisting of one sister and one daughter, and are in different states. I have not told my daughter about this and am debating what to say to her. I would appreciate any suggestions and thank you for replying. I feel very alone right now .
@alju
I live in California, I don't think there are any Mayo Clinics near me. I'm just outside of Los Angeles.