Treating Dementia

Medications

Medications being used or studied for possible use include:

• Cholinesterase inhibitors
• NMDA receptor antagonists
• Antioxidants (eg, vitamin E and others)
• Estrogens-Long-term use of estrogen therapy may put you at a higher risk for stroke , fractures, and gallbladder disease*¹
• Anti-inflammatory agents
• Ginkgo biloba (herbal supplement)-There are mixed reports on the effectiveness of this herb.*²

Only two types of medications have been approved to reduce the symptoms of Alzheimer's disease:

• Cholinesterase inhibitors-approved and recommended for mild-moderate Alzheimer's disease:
  • Donepezil (Aricept)
  • Rivastigmine (Exelon)
  • Galantamine (Reminyl)

• NMDA receptor antagonist-approved for moderate to severe Alzheimer's disease:
  • Memantine (Namenda)

These medications only have a modest effect on the disease.

Lifestyle Management

This type of support is critical for people with dementia. Behavioral and environmental support includes:

• Keeping you safe in your home
• Providing a calm, quiet, predictable environment
• Providing appropriate eyewear and hearing aids, easy-to-read clocks, and calendars
• Music therapy and/or dance therapy
• Encouraging light exercise to reduce agitation and relieve depression
• Discussing healthcare wishes with family members and doctors, and appointing a healthcare proxy and a legal power of attorney

Psychiatric Medications

People with dementia often develop psychiatric symptoms and may need appropriate treatment, such as:

• Antidepressants
• Anxiolytics-to treat anxiety
• Antipsychotics-to treat severe confusion, paranoia, and/or hallucinations
  • These must be used with caution. There are reports of increased risk for stroke or death in elderly patients with dementia.
• Mood stabilizers-to treat dangerous or disruptive behaviors

Caregiver Support

Caring for a person with dementia is very difficult. Those providing care will need support. The Alzheimer’s Association is an excellent resource for families and caregivers.