Treatment and Drug Options for Alzheimer's Disease
Currently, there is no cure for Alzheimer’s disease. Medical science still does not know why Alzheimer’s disease affects some people and not others. Researchers worldwide still search for its causes, as well as ways to prevent it, detect it very early, or stop the progression of the disease once someone has it.
That doesn’t mean that Alzheimer’s patients and their physicians are without options.
- Some medications help control or delay symptoms for a time, particularly in the early stages of the disease.
- Other drug treatments can help manage mental or emotional health symptoms like depression or agitation.
- Behavioral or environmental strategies—actions that can help reduce stress in a patient’s daily activities, for example—may reduce anxiety and manage conditions without medical intervention.
FDA-Approved Drugs to Help Control Symptoms
The U.S. Food and Drug Administration (FDA) has approved the following medications that may help regulate or manage Alzheimer’s disease symptoms. They do so by regulating neurotransmitters, the brain chemicals that transmit messages between neurons.
Four of the approved drugs work by addressing the low levels in Alzheimer’s patients of acetylcholine, an important brain chemical. The medications slow down this chemical breakdown, which in turn may slow down the progression of cognitive symptoms.
The drugs are:
- Aricept® (donepezil)
- Exelon® (rivastigmine)
- Cognex® (tacrine)
- Razadyne® (galantamine)
The FDA has approved all four drugs for management of mild to moderate Alzheimer’s symptoms, although Cognex® (tacrine) is now rarely used due to the severity of side effects. Aricept® is also approved for severe Alzheimer’s symptoms.
A fifth drug, Namenda® (memantine), is approved for treatment of moderate to severe Alzheimer’s disease. It appears to protect the brain’s nerve cells against excessive amounts of the chemical glutamate, a condition caused by damaged cells in Alzheimer’s.
Namzaric® is a combination of two drugs mentioned above: memantine (Namenda) and donepezil (Aricept). Namzaric capsules can be opened to allow the contents to be sprinkled on food to facilitate dosing for patients who may have difficulty swallowing.
How these Drugs Work
These drugs may work for some people but not others, and they do not stop the progression of Alzheimer’s disease. Instead, the drugs may delay it or help with symptom control for a period of time, particularly in the earlier stages of the disease. This action, in turn, may help patients with their attention and focus, cognitive abilities, memory, and communication skills.
Always talk to a doctor about the pros and cons of trying a particular drug treatment, alone or in combination with other drugs or with behavioral approaches. Even if certain medicines are well tolerated by most patients, drugs may have side effects such as:
- Loss of appetite
- Trouble sleeping
For more information on Alzheimer’s drug symptoms and effectiveness, see our factsheet on Treatments for Alzheimer’s Disease.
Treatments for Anxiety, Depression, and Psychosis
Often, as Alzheimer’s disease progresses, people experience depression, agitation, and psychotic symptoms such as paranoid thoughts or hallucinations. This may lead to behavior problems like:
- Sleeping difficulty
- Verbal actions like screaming
- Physical actions like hoarding or pacing
It’s important to see a physician to rule out any other medical conditions or drug interactions as the cause of these problems. Read more about medical conditions and medicines that can mimic dementia.
Environmental Factors that Affect Mood
Medications like anti-depressants may help reduce anxiety or depression. Before any drug therapies, however, physicians and family caregivers will want to review what may be triggering these symptoms to see whether any behavioral approaches may help.
For example, a change in routine, caregivers, or surroundings can cause fear, anxiety, or fatigue in the patient, and lead to agitation. The person with Alzheimer’s may be:
- Forgetting how to respond appropriately
- Frustrated by his or her limitations
- Misunderstanding what is happening
- Unable to communicate
In these cases, nonmedical intervention may be appropriate, which can include steps like:
- Creating a calm room for the patient that avoids noise and distractions
- Keeping changes in routine to a minimum
- Providing a security object or a pleasurable activity like listening to music
- Regularly monitoring the patient’s personal comfort
For more about behavioral and environmental approaches, read our article, “Managing Negative Reactions—Minimizing the Triggers of Alzheimer’s Behaviors.” If nonmedical intervention does not work or the person becomes a danger to himself or others, consult a physician to evaluate the need for medical treatments.
Warnings about Antipsychotic Medication: Be aware of the alert issued by the FDA that certain antipsychotic drugs are associated with an increased risk of stroke and death in older adults with dementia. Always discuss the potential risks and benefits of any proposed medication with your physician.
Help Find Future Treatments: Participate in Clinical Trials for Alzheimer’s Disease Research
According to the National Institutes of Health (NIH), more than 150 active clinical trials and studies are underway in the United States to better understand, prevent, and find new treatments for Alzheimer’s disease. At least 70,000 volunteers are needed to participate in these trials, which will help find cures for future generations. You do not have to have Alzheimer’s to participate.
Learn more about how to find and participate in clinical trials.