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Treatments and drugs

By Mayo Clinic staff

Most types of dementia can't be cured. However, doctors will help you manage your symptoms. Treatment of dementia symptoms may help slow or minimize the development of symptoms.

  • Cholinesterase inhibitors. These medications — including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — work by boosting levels of a chemical messenger involved in memory and judgment.

    Side effects can include nausea, vomiting and diarrhea. Although primarily used to treat Alzheimer's disease, these medications may also treat vascular dementia, Parkinson's disease dementia and Lewy body dementia.

  • Memantine. Memantine (Namenda) works by regulating the activity of glutamate. Glutamate is another chemical messenger involved in brain functions, such as learning and memory. A common side effect of memantine is dizziness.

    Some research has shown that combining memantine with a cholinesterase inhibitor may have beneficial results.

  • Other medications. Your doctor may prescribe other medications to treat other symptoms or conditions, such as a sleep disorder.
  • Occupational therapy. Your doctor may suggest occupational therapy to help you adjust to living with dementia. Therapists may teach you coping behaviors and ways to adapt movements and daily living activities as your condition changes.

Therapies
Several dementia symptoms and behavior problems may be treated initially using nondrug approaches, such as:

  • Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to focus and function. It also may reduce confusion and frustration.
  • Modifying your responses. A caregiver's response to a behavior can make the behavior, such as agitation, worse. It's best to avoid correcting and quizzing a person with dementia. Reassuring the person and validating his or her concerns can defuse most situations.
  • Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine during the day also help reduce confusion in people with dementia.
References
  1. Dementia: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm?css=. Accessed Jan. 18, 2013.
  2. What is dementia? Alzheimer's Association. http://www.alz.org/what-is-dementia.asp. Accessed Jan. 18, 2013.
  3. Shadlen MF, et al. Evaluation of cognitive impairment and dementia. http://www.uptodate.com/home. Accessed Feb. 1, 2013.
  4. Hake AM, et al. Epidemiology, pathology, and pathogenesis of dementia with Lewy bodies. http://www.uptodate.com/home. Accessed Jan. 18, 2013.
  5. Hake AM, et al. Clinical features and diagnosis of dementia with Lewy bodies. http://www.uptodate.com/home. Accessed Jan. 18, 2013.
  6. Types of dementia. Alzheimer's Association. http://www.alz.org/dementia/types-of-dementia.asp. Accessed Jan. 18, 2013.
  7. Vascular dementia. Alzheimer's Association. http://www.alz.org/dementia/vascular-dementia-symptoms.asp. Accessed Feb. 11, 2013.
  8. Frontotemporal dementia (FTD). Alzheimer's Association. http://www.alz.org/dementia/fronto-temporal-dementia-ftd-symptoms.asp. Accessed Feb. 11, 2013.
  9. Rodnicksky RL. Parkinson disease dementia. http://www.uptodate.com/home. Accessed Feb. 11, 2013.
  10. Press D, et al. Prevention of dementia. http://www.uptodate.com/home. Accessed Dec. 20, 2012.
  11. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Jan. 28, 2013.
  12. Shadlen MF, et al. Risk factors for dementia. http://www.uptodate.com/home. Accessed Jan. 18, 2013.
  13. Press D, et al. Treatment of dementia. http://www.uptodate.com/home. Accessed Jan. 18, 2013.
  14. Press D, et al. Cholinesterase inhibitors in the treatment of dementia. http://www.uptodate.com/home. Accessed Feb. 12, 2013.
  15. Press D, et al. Safety and societal issues related to dementia. http://www.uptodate.com/home. Accessed Feb. 12, 2013.
  16. Press D, et al. Treatment of behavioral symptoms related to dementia. http://www.uptodate.com/home. Accessed Feb. 12, 2013.
  17. Eating. Alzheimer's Association. http://www.alz.org/care/alzheimers-food-eating.asp. Accessed Feb. 11, 2013.
  18. The changing brain in AD. National Institute on Aging. http://www.nia.nih.gov/alzheimers/publication/part-2-what-happens-brain-ad/changing-brain-ad. Accessed Feb. 13, 2013.
  19. Personal care: Assisting a person with dementia with changing daily needs. Alzheimer's Association. http://www.alz.org/care/alzheimers-dementia-dressing.asp. Accessed Feb. 11, 2013.
  20. Communication and Alzheimer's. Alzheimer's Association. http://www.alz.org/care/dementia-communication-tips.asp. Accessed Feb. 4, 2013.
  21. Creating a daily plan. Alzheimer's Association. http://www.alz.org/care/dementia-creating-a-plan.asp. Accessed Feb. 4, 2013.
  22. Early-stage caregiving. Alzheimer's Association. http://www.alz.org/care/alzheimers-early-mild-stage-caregiving.asp. Accessed Feb. 13, 2013.
  23. Sleep issues and sundowning. Alzheimer's Association. http://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.asp. Accessed Feb. 4, 2013.
  24. Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp. Accessed Feb. 13, 2013.
  25. Wollen KA. Alzheimer's disease: The pros and cons of pharmaceutical, nutritional, botanical, and stimulatory therapies, with a discussion of treatment strategies from the perspective of patients and practitioners. Alternative Medicine Review. 2010;15:223.
  26. Buettner LL, et al. Animal-assisted therapy for clients with dementia. Journal of Gerontological Nursing. 2011;37:10.
  27. Being a healthy caregiver. Alzheimer's Association. http://www.alz.org/care/alzheimers-dementia-healthy-caregiver.asp. Accessed Feb. 4, 2013.
  28. Taking care of yourself. Alzheimer's Association. http://www.alz.org/living_with_alzheimers_taking_care_of_yourself.asp. Accessed Feb. 12, 2013.
  29. Caregiver stress. Alzheimer's Association. http://www.alz.org/care/alzheimers-dementia-caregiver-stress-burnout.asp. Accessed Feb. 4, 2013.
  30. Graff-Radford NR (expert opinion). Mayo Clinic, Jacksonville, Fla. March 4, 2013.
  31. Graff-Radford NR. Normal pressure hydrocephalus. http://www.uptodate.com/home. Accessed March 4, 2013.
DS01131 April 16, 2013

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