Medications for Dementia
When someone you care about has dementia, their memory loss is affecting their daily life. You want to find a medication that can help them. There are medicines that can help.
What Is Aducanumab-avwa (Aduhelm)?
This is the first drug approved by the FDA to treat Alzheimer’s disease in decades. If your loved one is in the early stages of Alzheimer’s disease, the most common form of dementia, their doctor may prescribe this monthly infusion.
What it does: It’s a monoclonal antibody that lessens the buildup of things called amyloid plaques in your brain. These plaques are part of what leads to the memory loss associated with Alzheimer’s disease.
What to expect: For people with mild cognitive impairment (MCI) or early Alzheimer’s disease, the drug appears to slow down the progression of Alzheimer’s disease.
Side effects: The most common appears to be something called ARIA: amyloid-related imaging abnormalities. One study suggests that 41% of people who take this drug will develop ARIA. These problems include temporary swelling in the brain and small areas of bleeding.
What is lecanemab-irmb (Leqembi)?
This drug is also approved to treat the early stages of Alzheimer’s disease. It may be prescribed as an infusion administered every two weeks.
What it does: It’s a monoclonal antibody that lessens the buildup of amyloid plaques in your brain.
What to expect: For people with mild cognitive impairment (MCI) or early Alzheimer’s disease, the drug appears to slow down the progression of Alzheimer’s disease.
Side effects: In addition to possible flu-like symptoms, patients may also develop ARIA. There is also the possibility of temporary swelling in the brain and small areas of bleeding.
What Are Cholinesterase Inhibitors?
If your loved one has Alzheimer’s disease that isn’t too severe yet, their doctor might prescribe them a cholinesterase inhibitor. If they have another type of dementia, their doctor may consider it, too.
What they do: Scientists think these help prevent a “messenger chemical” in our brains called acetylcholine from breaking down. Acetylcholine is important in learning, memory, and mood. Cholinesterase inhibitors also appear to delay the worsening of Alzheimer’s symptoms.
These medicines include:
What to expect: Most people with Alzheimer’s who take one of these medications get some benefit from it, including less anxiety, improved motivation, and better concentration and memory. And some are able to continue with their regular activities.
But the improvements don’t seem to last long — about 6 to 12 months. They mainly delay the worsening of the disease for a period of time.
All three medicines work similarly, but one might work better for your loved one than it does for someone else.
Side effects: Most people don’t have side effects when they take cholinesterase inhibitors, but some do have:
- Nausea
- Vomiting
- Loss of appetite
- More frequent bowel movements
- Bruising
- Muscle cramps
- Headaches
- Fatigue
- Insomnia
What Is Memantine?
If your loved one has moderate to severe Alzheimer’s, their doctor may prescribe them memantine (Namenda) for their symptoms.
What it does: Memantine could help improve memory, attention, reasoning, and language. Your doctor may also prescribe it with donepezil (Aricept).
Memantine helps balance glutamate, which is another “messenger chemical” involved in our memory and learning.
What to expect: Studies show that memantine can curb delusions (believing things that aren’t true), hallucinations (seeing things that aren’t there), agitation, aggression, and irritability. It can also help your loved one with disorientation and make their daily activities easier.
Memantine comes in immediate-release tablets, extended-release tablets, and oral drops.
Side effects: The side effects aren’t as bad or as common as the side effects of cholinesterase inhibitors, and include:
- Constipation
- Dizziness
- Headache
- Confusion
- Fatigue