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Treatments and drugs
By Mayo Clinic staffCurrently, there's no cure for Alzheimer's disease. Doctors sometimes prescribe drugs to improve signs and symptoms that often accompany Alzheimer's, including sleeplessness, wandering, anxiety, agitation and depression. But only two varieties of medications have been proved to slow the cognitive decline associated with Alzheimer's.
Cholinesterase inhibitors
This group of medications — which includes donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — works by improving the levels of neurotransmitters in the brain. But cholinesterase inhibitors don't work for everyone. As many as half the people who take these drugs show no improvement. Other people may choose to stop taking the drugs because of the side effects, which include diarrhea, nausea and vomiting.
Memantine (Namenda)
The first drug approved to treat moderate to severe stages of Alzheimer's, memantine protects brain cells from damage caused by the chemical messenger glutamate. It sometimes is used in combination with a cholinesterase inhibitor. Memantine's most common side effect is dizziness, although it also appears to increase agitation and delusional behavior in some people.
- Alzheimer's disease fact sheet. National Institute on Aging. http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm. Accessed Oct. 31, 2008.
- Shadlen MF, et al. Evaluation of cognitive impairment and dementia. http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2008.
- Caselli RJ, et al. The degenerative dementias: Alzheimer's disease. In: Goetz CG, et al. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/109112945-3/0/1488/287.html. Accessed Nov. 3, 2008.
- Alzheimer's information: Causes. National Institute on Aging. http://www.nia.nih.gov/Alzheimers/AlzheimersInformation/Causes/. Accessed Nov. 6, 2008.
- Shadlen MF, et al. Dementia syndromes. http://www.uptodate.com/home/index.html. Accessed Nov. 6, 2008.
- Basics of Alzheimer's disease: What it is and what you can do. Alzheimer's Association. http://www.alz.org/national/documents/brochure_basicsofalz_low.pdf. Accessed Nov. 6, 2008.
- Alzheimer's disease genetics fact sheet. National Institute on Aging. http://www.nia.nih.gov/Alzheimers/Publications/geneticsfs.htm. Accessed Nov. 6, 2008.
- Shadlen MF, et al. Risk factors for dementia. http://www.uptodate.com/home/index.html. Accessed Nov. 6, 2008.
- Kelley BJ, et al. Alzheimer's disease and mild cognitive impairment. Neurological Clinics. 2007;25:577.
- Late-stage care. Alzheimer's Association. http://www.alz.org/national/documents/brochure_latestage.pdf. Accessed Nov. 7, 2008.
- Dementia care practice recommendations for assisted living residences and nursing homes. Alzheimer's Association. http://www.alz.org/national/documents/brochure_DCPRphases1n2.pdf. Accessed Nov. 7, 2008.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Nov. 7, 2008.
- Press D, et al. Cholinesterase inhibitors in the treatment of dementia. http://www.uptodate.com/home/index.html. Accessed Nov. 7, 2008.
- Press D, et al. Treatment of dementia. http://www.uptodate.com/home/index.html. Accessed Nov. 7, 2008.
- Press D, et al. Prevention of dementia. http://www.uptodate.com/home/index.html. Accessed Nov. 7, 2008.
- Natural medicines in the clinical management of Alzheimer's disease. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Nov. 10, 2008.
- Alexander M, et al. Patient information: Alzheimer's disease. http://www.uptodate.com/patients/content/topic.do?topicKey=~eWpcYl7lC9LRwe. Accessed Nov. 10, 2008.
- Press D, et al. Future directions in dementia treatments. http://www.uptodate.com/home/index.html. Accessed Nov. 7, 2008.
- Smith GE (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 19, 2008.
- DeKosky ST, et al. Ginkgo biloba for prevention of dementia: A randomized controlled trial. Journal of the American Medical Association. 2008;19:2253.
