Drug treatments for Alzheimer's disease
There's no drug to cure dementia yet, but it's often possible to relieve some symptoms. Learn more about the main drug treatments for Alzheimer's disease.There are no drug treatments that can cure Alzheimer’s disease or any other common type of dementia.
However, there are medicines for Alzheimer’s disease that can ease symptoms for a while, or slow down their progression, in some people. These drugs do not slow down or stop the progression of the underlying disease in the brain.
Medication can be an important part of a person’s treatment for Alzheimer’s disease. However, drugs can only help with some symptoms and should only be one part of a person’s care. Information and advice, activities, support and treatments that don’t involve drugs are just as important in helping someone to live well with Alzheimer’s disease. A person with Alzheimer’s disease can look at
What are the main drugs used to treat Alzheimer's disease?
Many drugs have at least two names:
a name for the main substance in the medicine (such as paracetamol)
a brand name (such as Panadol or Calpol).
Drugs are sometimes made with only the name of the substance (such as paracetamol) on the packaging. There are four drugs for Alzheimer’s disease:
Substance name Examples of brand names (UK):
Donepezil
Aricept
Rivastigmine
Exelon
Galantamine
Reminyl, Acumor XL*, Galsya XL*, Gatalin XL*
Memantine
Ebixa, Nemdatine, Alzhok
*XL refers to a drug that is in a slow-release form. See Taking the drugs.
Donepezil, rivastigmine and galantamine work in a similar way and are all known as ‘acetylcholinesterase inhibitors’. (This is often shortened to ‘cholinesterase inhibitors’.)
Memantine works differently to the other drugs, and is known as an ‘NMDA receptor antagonist’.
Drugs that may change or delay progression of the disease
Drugs in this category may delay clinical decline with benefits to both cognition and function in people living with Alzheimer’s disease. While there are currently no approved drugs in this category, there are several under review by the U.S. Food and Drug Administration (FDA) and being tested in clinical trials. These drugs aim to change the underlying biology of the disease, with a goal of slowing down or stopping its progression.
Drugs that treat symptoms
Cognitive symptoms (memory and thinking)
As Alzheimer’s progresses, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While these medications do not stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among and between the brain's nerve cells.
The following medications are prescribed to treat symptoms related to memory and thinking.
Cholinesterase inhibitors (Aricept®, Exelon®, Razadyne®)
Cholinesterase (KOH-luh-NES-ter-ays) inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes. These medications prevent the breakdown of acetylcholine (a-SEA-til-KOHlean). Acetylcholine is a chemical messenger important for memory and learning. These drugs support communication between nerve cells.
The cholinesterase inhibitors most commonly prescribed are:
Donepezil (Aricept®): approved to treat all stages of Alzheimer’s disease.
Rivastigmine (Exelon®): approved for mild-to-moderate Alzheimer’s as well as mild-to-moderate dementia associated with Parkinson’s disease.
Galantamine (Razadyne®): approved for mild-to-moderate stages of Alzheimer’s disease.
Though generally well-tolerated, if side effects occur, they commonly include nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Glutamate regulators (Namenda®)
Glutamate regulators are prescribed to improve memory, attention, reason, language and the ability to perform simple tasks. This type of drug works by regulating the activity of glutamate. Glutamate is a different chemical messenger that helps the brain process information.
This drug is known as:
Memantine (Namenda®): approved for moderate-to-severe Alzheimer’s disease.
Can cause side effects, including headache, constipation, confusion and dizziness.
Cholinesterase inhibitor + glutamate regulator (Namzeric®)
This type of drug is a combination of a cholinesterase inhibitor and a glutamate regulator.
Donepezil and memantine (Namzaric®): approved for moderate-to-severe Alzheimer’s disease.
Possible side effects include nausea, vomiting, loss of appetite, increased frequency of bowel movements, headache, constipation, confusion and dizziness.
Non-cognitive symptoms (behavioral and psychological symptoms)
Alzheimer’s affects more than just memory and thinking. A person’s quality of life may be impacted by a variety of behavioral and psychological symptoms that accompany dementia, such as sleep disturbances, agitation, hallucinations and delusions. Some medications focus on treating these non-cognitive symptoms for a time, though it is important to try non-drug strategies to manage behaviors before adding medications.
At this time, the FDA has approved one drug to address insomnia in people living with dementia, but trials into drugs that address other non-cognitive symptoms are underway.
Orexin receptor antagonist (Belsomra®)
Prescribed to treat insomnia for individuals living with dementia, this drug is thought to inhibit the activity of orexin, a type of neurotransmitter involved in the sleep-wake cycle:
Suvorexant (Belsomra®): approved for mild-to-moderate Alzheimer’s disease.
Possible side effects include, but are not limited to: risk of impaired alertness and motor coordination (including impaired driving), worsening of depression or suicidal thinking, complex sleep behaviors (such as sleep-walking and sleep-driving), sleep paralysis and compromised respiratory function.
Side Effects
Nausea, vomiting, loss of appetite, muscle cramps and increased frequency of bowel movements.
Nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Headache, constipation, confusion and dizziness.
Nausea, vomiting, loss of appetite, increased frequency of bowel movements, headache, constipation, confusion and dizziness.
Impaired alertness and motor coordination, worsening of depression or suicidal thinking, complex sleep behaviors, sleep paralysis, compromised respiratory function.
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