We’re used to taking medication to tackle many health problems. But when it comes to common types of dementia, such as Alzheimer’s disease, drugs may ease some of the symptoms for some dementia sufferers, but they will not cure the condition.
Our guide to dementia drugs covers which drugs may be prescribed to help with different types of dementia.
Related: Learn more about the different types of dementia
There are two main types of drug used in Alzheimer’s disease treatment.
Acetylcholinesterase inhibitors, (also known as cholinesterase inhibitors)
When these are prescribed it is usually for people who are in the early-to-mid stages of Alzheimer’s disease. They can be prescribed by a specialist, such as a physician who specialises in the health care of older people, a psychiatrist, or a neurologist.
If you are prescribed any of the drugs in this group, you’ll have just one of them at a time. In some cases people may get on better with one of these drugs than another. If the first one you try doesn’t suit you, your doctor may suggest trying a different one.
There are three different cholinesterase inhibitors. These are donepezil, rivastigmine and galantamine. These are the generic names for these three drugs.
(Generic means that the patent on these drugs has run out, so different companies can produce them. They should work just as well as the original drug, and should be cheaper too.)
Donepezil: you may see the brand name Aricept on your medication. They are the same drug, just different names.
Rivastigmine: the identical drug is available under a number of brand names, including Exelon.
Galantamine: this too is available under a number of brand names, including Reminyl XL, Acumor XL, and Gatalin XL.
NMDA receptor antagonist
The other type of drug used in Alzheimer’s disease is an NMDA receptor antagonist. The generic name of this drug is memantine. You may be prescribed memantine under a brand name. These include Ebixa, Maruxa and Nemdatine.
Related: Read more about treatments for Alzheimer’s disease
Dementia with Lewy bodies
Using medication to help ease the symptoms of Dementia with Lewy bodies, can be very difficult, and unpredictable. Because of this, any drugs are prescribed with great caution.
The acetylcholinesterase inhibitors that may be prescribed for people with Alzheimer’s disease, are also sometimes used to help ease the symptoms of people with Dementia with Lewy bodies (DLB).
Donepezil (brand name Aricept), galantamine (brand name Reminyl XL), or rivastigmine (brand name Exelon) may help to reduce some specific symptoms that come with DLB. These include hallucinations, drowsiness and confusion.
At the moment none of the drugs named above are licensed for use for people with DLB. This can mean that doctors are hesitant about prescribing them for people with DLB. Talk to your doctor about whether they think this type of drug would help, and whether they could prescribe it ‘off label’. (This means that the drug will be used for a condition for which it hasn’t been approved.) Learn more about off-label prescribing at www.nhs.uk.
There are other medicines that may be prescribed to help with the symptoms of DLB.
Antidepressants may help if you are suffering with depression.
Clonazepam can help if you are having disturbed sleep – one of the symptoms of DLB.
Levodopa is sometimes helpful, as it can help reduce the movement problems that come with DLB. However, it can make other symptoms, such as hallucinations, worse. (This drug is also used to treat Parkinson’s disease.)
In some cases antipsychotic drugs are prescribed to help people with dementia if they have been suffering from hallucinations or are very agitated. In the case of people with DLB, these should be avoided if at all possible as they may cause serious side effects.
Related: Learn more about dementia with Lewy Bodies
Frontotemporal dementia (Pick’s disease)
There are only a few medications available that are suitable for people who have frontotemporal dementia. Selective serotonin reuptake inhibitors (SSRIs), which are a form of antidepressant, may help to control some of the symptoms experienced by some people with frontotemporal dementia.
These symptoms include compulsive behaviour, overeating and uninhibited behaviour that can affect some people with this condition. Trazodone, another type of antidepressant, may also help to manage behavioural problems.
If frontotemporal dementia is causing very aggressive, and potentially harmful behaviour, the medical team may consider prescribing an antipsychotic (risperidone is the only antipsychotic currently licensed for use in people with dementia). However, this type of drug will only be given for a short time, and at a very low dose, as it may cause potentially harmful side effects.
If you have vascular dementia following a stroke, your doctor may suggest that you have treatment to reduce risk of further strokes.
This can include taking statins for high cholesterol, or warfarin or a similar anticoagulant to help guard against further blood clots. Anti-platelets – for instance aspirin - are another type of drug that can help prevent blood clots and reduce your risk of having another stroke.
If you have high blood pressure, beta blockers and anti-hypertensives may also be added to your prescription list.
Related: Learn more about vascular dementia