Although current medications cannot cure Alzheimer’s or stop it from progressing, they may help lessen symptoms, such as memory loss and confusion, for a limited time.
- Types of drugs
- How medications work
- Early/moderate stages
- On the horizon
- Moderate/severe stages
Types of drugs
The U.S. Food and Drug Administration (FDA) has approved two types of medications — cholinesterase inhibitors (Aricept®, Exelon®, Razadyne®) and memantine (Namenda®) — to treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer’s disease.
As Alzheimer’s progresses, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While current medications cannot stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain’s nerve cells. Doctors sometimes prescribe both types of medications together.
Before beginning a new medication, make sure your physician and pharmacist are aware of all medications currently being taken (including over-the-counter and alternative preparations). This is important to make certain medications will not interact with one another, causing side effects.
Medications for early to moderate stages
All of the prescription medications currently approved to treat Alzheimer’s symptoms in early to moderate stages are from a class of drugs called cholinesterase inhibitors. Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes.
Additionally, cholinesterase inhibitors:
- Prevent the breakdown of acetylcholine (a-SEA-til-KOH-lean), a chemical messenger important for learning and memory. This supports communication among nerve cells by keeping acetylcholine high.
- Delay or slow worsening of symptoms. Effectiveness varies from person to person.
- Are generally well-tolerated. If side effects occur, they commonly include nausea, vomiting, loss of appetite and increased frequency of bowel movements. It is strongly recommended that a physician who is experienced in using these medications monitor patients who are taking them and that the recommended guidelines be strictly observed.
Three cholinesterase inhibitors are commonly prescribed:
- Donepezil (marketed under the brand name Aricept), which is approved to
treat all stages of Alzheimer’s disease.
- Galantamine (Razadyne), approved for mild-to-moderate stages.
- Rivastigmine (Exelon), approved for mild-to-moderate Alzheimer’s as well
as mild to moderate dementia associated with Parkinson’s disease.
Medications for moderate to severe stages
Memantine (Namenda) and a combination of memantine and donepezil (Namzaric®) are approved by the FDA for treatment of moderate to severe Alzheimer’s.
Memantine is prescribed to improve memory, attention, reason, language and the ability to perform simple tasks. It can be used alone or with other Alzheimer’s disease treatments. There is some evidence that individuals with moderate to severe Alzheimer’s who are taking a cholinesterase inhibitor might benefit by also taking memantine. A medication that combines memantine and a cholinesterase inhibitor is available.
- Regulates the activity of glutamate, a chemical involved in information processing, storage and retrieval.
- Improves mental function and ability to perform daily activities for some people..
- Can cause side effects, including headache, constipation, confusion and dizziness.
How Alzheimer’s medications work
To understand how Alzheimer’s medications work, you first need to understand the communication network in the brain. The picture below depicts nerve cells, or neurons, in the brain. Neurons are the chief cells destroyed by Alzheimer’s disease.
In the brain, neurons connect and communicate at synapses, where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Alzheimer’s disrupts this process, and eventually destroys synapses and kills neurons, damaging the brain’s communication network.
On the horizon
Scientists have made remarkable progress in understanding how Alzheimer’s disease affects the brain. Their insights point toward promising new treatments to slow or stop the disease.
Ultimately, the path to effective therapies is through clinical studies. Learn more about Alzheimer’s Association TrialMatch®, a free clinical studies matching service, and how you can participate in vital Alzheimer’s disease research.
|Generic||Brand||Approved For||Side Effects|
|Donepezil||Aricept||All stages||Nausea, vomiting, loss of appetite, muscle cramps and increased frequency of bowel movements.|
|Galantamine||Razadyne||Mild to moderate||Nausea, vomiting, loss of appetite and increased frequency of bowel movements.|
|Memantine||Namenda||Moderate to severe||Headache, constipation, confusion and dizziness.|
|Rivastigmine||Exelon||Mild to moderate||Nausea, vomiting, loss of appetite and increased frequency of bowel movements.|
|Memantine + Donepezil||Namzaric||Moderate to severe||Nausea, vomiting, loss of appetite, increased frequency of bowel movements, headache, constipation, confusion and dizziness.|