Overview

Dementia is a term that describes a wide range of symptoms associated with a decline in memory or other cognitive skills. This decline is severe enough to make you less able to perform everyday activities.

Alzheimer’s disease (AD) is the most common form of dementia. Other common types include:

There’s no known cure for any type of dementia, and medications can’t prevent the condition or reverse the brain damage it causes. However, various drugs can provide some symptom relief.

Read on to learn what these drugs may do to ease dementia symptoms for you or your loved one.

Several prescription medications are approved by the Food and Drug Administration (FDA) to treat symptoms of dementia caused by AD. These drugs can provide short-term relief from cognitive dementia symptoms. Some can also help slow the progression of AD-related dementia.

While these drugs are approved to treat symptoms of AD, they’re not approved to treat symptoms of other types of dementia. However, researchers are exploring off-label uses of these medications for people with non-AD dementias.

OFF-LABEL DRUG USE

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that hasn’t been approved. However, a doctor can still use the drug for that purpose. The FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.

According to the Alzheimer’s Association, some AD medications may benefit people with Parkinson’s disease dementia and vascular dementia.

Some of the most commonly prescribed medications used to treat symptoms of AD are cholinesterase inhibitors and memantine.

Cholinesterase inhibitors work by increasing acetylcholine, a chemical in your brain that aids in memory and judgment. Increasing the amount of acetylcholine in your brain may delay dementia-related symptoms. It may also prevent them from worsening.

The more common side effects of cholinesterase inhibitors include:

Some commonly prescribed cholinesterase inhibitors are:

Donepezil (Aricept)

Donepezil (Aricept) is approved to delay or slow the symptoms of mild, moderate, and severe AD. It may be used off-label to help reduce behavioral symptoms in some people with thought problems following a stroke, LBD, and vascular dementia.

It’s available as a tablet.

Galantamine (Razadyne)

Galantamine (Razadyne) is approved to prevent or slow the symptoms of mild to moderate AD. It may be used off-label to help provide the same benefit for people with LBD or vascular dementia.

It’s available as a tablet, an extended-release capsule, and an oral solution.

Rivastigmine (Exelon)

Rivastigmine (Exelon) is approved to prevent or slow the symptoms of mild to moderate AD or mild to moderate Parkinson’s dementia.

It’s available as a capsule and as an extended-release skin patch.

Memantine (Namenda) is mainly used to delay increasing cognitive and behavioral symptoms caused by moderate to severe AD. This effect may allow people with AD to function more normally for a longer time.

Memantine may be used off-label to provide the same benefit for people with vascular dementia.

Memantine isn’t a cholinesterase inhibitor, but it also acts on chemicals in the brain.

In fact, memantine is often prescribed in combination with a cholinesterase inhibitor. An example of this combination is Namzaric. The medication combines extended-release memantine with donepezil.

Memantine is available as a tablet, an extended-release capsule, and an oral solution.

Its more common side effects include:

Effectiveness varies by drug. For all of these dementia drugs, however, the effectiveness tends to decrease over time.

While there’s no cure for dementia, several prescription medications can help slow the progression of its symptoms and cognitive effects.

If you or a loved one has dementia, talk to your doctor about all of the treatment options. Don’t hesitate to ask questions. Examples of questions you can ask include:

  • What type of dementia is it?
  • Which medications will you prescribe?
  • What results should I expect from this medication?
  • What other treatments are available?
  • How long should I expect this medication to help?

Q:

What is Lewy body dementia and what drugs are used to treat it?

Anonymous patient

A:

Lewy body dementia is a progressive disease that causes protein deposits, known as Lewy bodies, in nerve cells of the brain. These protein deposits impact behavior, memory, movement, and personality. Symptoms of the disease often include hallucinations and delusions, confusion, attention changes, and Parkinson’s symptoms, such as hunched posture, balance problems and rigid muscles.

Lewy body dementia is commonly misdiagnosed as Alzheimer’s disease. The symptoms of the disease are similar to Alzheimer’s and Parkinson’s, but treatment is challenging as few medications can be used safely and there’s no cure for the disease.

Medications are used to treat individual symptoms and include cholinesterase inhibitors and Parkinson’s disease medications, such as carbidopa-levodopa to treat movement issues. A treatment plan should be monitored closely by a doctor experienced with treating Lewy body dementia.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.