Dementia Medication: A Complete Guide

Medically Reviewed By Philip Ngo, PharmD

While there is currently no cure for dementia, there are various medications that can help manage and slow the progression of the condition. Dementia is an impaired ability to make decisions, remember, and think clearly. This can affect a person’s ability to perform typical everyday tasks.

There are different types of dementia. These include Alzheimer’s disease and Lewy body dementia.

Dementia generally affects older adults. However, it is not considered to be a typical part of aging. Many older adults can live their entire lives without developing dementia. Certain memory-related issues are typical with aging. However, they are generally mild compared to those associated with dementia.

There is no cure for dementia, though research is ongoing. There are medications that can help manage the progression of the condition.

This article discusses some of the medications to help manage the progression and symptoms of dementia.

Medications to change dementia progression

A younger adult helping an older adult with a pill box
Photography by Maskot/Getty Images

Currently, there is no cure for dementia. However, several medications can manage and slow its progression. Healthcare professionals can recommend the most appropriate treatment plan for people with dementia based on the type and severity of their symptoms.

The medications to change dementia progression may include Trusted Source National Institute on Aging Governmental authority Go to source :

  • anti-amyloid medications
  • glutamate regulators
  • cholinesterase inhibitors

Some experts suggest that glutamate and cholinesterase inhibitors may be more cost effective. Anti-amyloid medications are used only in the early stages of Alzheimer’s disease (AD) and can be expensive Trusted Source The Lancet Highly respected journal, Expert written journal, Peer reviewed journal Go to source . Talk with your medical team if you have questions about the cost and effectiveness of different medication options.

Anti-amyloid medications

Anti-amyloid drugs work by binding to and eliminating beta-amyloid, a protein that accumulates into plaques, from your brain. There are several anti-amyloid medications, each targeting a different stage of plaque formation.

These drugs are usually effective in changing the course of dementia in its early stages, giving people with the condition more time to live independently and do their daily activities. Taking anti-amyloid medications typically results in a reduction of cognitive and functional decline in people with dementia.

Anti-amyloid medications may include aducanumab (Aduhelm) and lecanemab (Leqembi). These medications come in the form of an intravenous (IV) infusion and can cause side effects such as headaches and falls. In some cases, people can develop serious allergic reactions.

Other medications healthcare professionals may prescribe if dementia is due to AD can include glutamate and cholinesterase inhibitors.

Glutamate regulators

People with AD may have too much glutamate, a chemical that damages the nerve cells and makes it more difficult for them to send messages. Glutamate regulators, such as memantine (Namenda), can help protect your nerve cells from glutamate by blocking it.

Cholinesterase inhibitors

Cholinesterase inhibitors can help stop the breakdown of acetylcholine, a chemical important for several brain functions, including thinking and memory. However, as AD causes your brain to produce less acetylcholine as it progresses, these medications may lose effectiveness over time.

Read about how to talk with a doctor about Alzheimer’s disease.

Medications to improve dementia symptoms

Healthcare professionals may prescribe medications to people with dementia to help them improve and manage their symptoms. These medications can have various purposes. Dementia drugs can help manage Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the cognitive and psychological symptoms that a person with dementia may develop.

Depending on the symptoms you or your loved one develops, healthcare professionals may recommend one or a combination of drugs to help function with dementia. People with AD or dementia can develop several psychological and behavioral symptoms that can significantly worsen their quality of life. This may include agitation, delusions, hallucinations, or insomnia.

Medications for cognitive symptoms

When dementia progresses, brain cells and their connections die. This can cause the cognitive symptoms to worsen. However, some medications can help reduce or stabilize the symptoms for some time by making changes in the chemical in the brain.

Cholinesterase inhibitors come in the form of oral tablets, and you should typically take them during morning and evening meals for better absorption. However, they are also available for intramuscular (IM) or IV administration.

Cholinesterase inhibitors can help with cognitive symptoms of dementia, such as:

  • memory
  • thinking
  • judgment
  • language

Some of the most commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). These medications can cause side effects, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

Glutamate regulators, similar to cholinesterase inhibitors, such as oral memantine (Namenda) can also help improve memory, reasoning, attention, and other cognitive symptoms of dementia. Taking glutamate regulators may cause side effects, including:

In some cases, healthcare professionals may prescribe medications that contain a combination of glutamate regulators and cholinesterase inhibitors, such as donepezil and memantine (Namzaric). However, this is a medication typically used for treating moderate-to-severe AD.

Medications for behavioral and psychological symptoms

Some medications can help improve the psychological and behavioral symptoms that people with dementia may develop as the condition progresses.

Orexin receptor antagonist medications, such as suvorexant (Belsomra), can help treat insomnia in people with dementia. This medication inhibits the function of orexin, a neurotransmitter that affects the sleep-wake cycle. This medication, however, can cause side effects, including:

Help is out there

If someone you know is at immediate risk of harming themselves or others, or at risk of suicide: 

  • Ask the question, “Are you considering suicide?” even if it is tough.
  • Listen without judgment.
  • Call 911 or your local emergency number.
  • Stay with them until emergency services arrive.
  • Try to remove any weapons, medications, or other potentially harmful items.

If you or someone you know is having suicidal thoughts, contact the 988 Suicide and Crisis Lifeline:

  • Call or text 988
  • Chat with the lifeline

This service is available 24/7.

If you or a loved one experiences any of these side effects after taking these medications, speak with a healthcare professional.

Atypical antipsychotics, such as brexpiprazole (Rexulti), can help improve the agitation people with this disease may experience. Doctors generally prescribe atypical antipsychotics for treating conditions such as bipolar disorder or schizophrenia, but they can also help Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source with dementia-related agitation.

Atypical antipsychotics work by targeting and making changes in the serotonin and dopamine chemical pathways in your brain, improving mood and reducing agitation. However, these drugs can cause side effects, including:

In some cases, atypical antipsychotics may be linked to an increased risk of death in people with dementia. If you or a loved one experiences any side effects after taking an atypical antipsychotic drug, speak with a healthcare professional.

Summary

Dementia is an impaired ability to think, remember, and make decisions. The types of dementia include Alzheimer’s disease and Lewy body dementia.

There is currently no cure for dementia. However, medications can help slow the progression of the condition and manage symptoms.

If you or a loved one are experiencing symptoms of dementia, speak with a healthcare professional. They can diagnose a condition and recommend the most effective medications to manage symptoms.

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Medical Reviewer: Philip Ngo, PharmD
Last Review Date: 2024 Feb 7
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