Introduction to Medications for Alzheimer's Symptom Management

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.