Dementia is a general term for the loss of memory caused by physical changes in the brain. Alzheimer’s is the most common type of dementia. Unfortunately, there are currently no medications that can reverse or halt disease progression for most of the dementias. There are five Alzheimer’s disease (AD) medications approved by the FDA that have been shown to provide some symptom relief. However, they can’t improve the underlying brain damage or even always clearly decrease the speed of cognitive decline.

The FDA has approved a group of medications for mild to moderate AD known collectively as cholinesterase inhibitors. These may delay or prevent Alzheimer’s symptoms from worsening, and they may help manage some of the behavioral symptoms that accompany a diagnosis of AD. These medications include donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). The first cholinesterase inhibitor FDA approved for AD was known as tacrine (Cognex). It’s been removed from the market due to safety concerns. 

For moderate to severe AD, the FDA has approved and additional medication that is not a cholinesterase inhibitor.  This medication is known as memantine (Namenda). Its primary use is to potential delay the decline in cognitive and behavioral symptoms in people with moderate to severe AD. This permits certain patients to retain some routine functionality longer than they would have without the medication. Donepezil has also been approved for use in more advanced AD.

The effectiveness of these medications is highly variable. Whatever effectiveness they do have tends to diminish over time. According to the Alzheimer’s Association there is also research suggesting that some of the AD medications may provide some benefit for vascular dementias and Parkinson's dementia. While these medications are intended to stop the progression of Alzheimer’s disease, additional medications may be required to alleviate the many challenging symptoms. These include:

  • antidepressants
  • anti-anxiety medication
  • sleep aids
  • antipsychotics

Here are some of the commonly prescribed medications and their uses.

Generic Name

(Brand Name Example)

 

Medication Use

Donepezil (Aricept)

 

Used to delay or slow the symptoms of AD.
• loses its effect over time
• used for mild, moderate, and severe AD
• does not prevent or cure AD

* may help reduce behavioral symptoms in some people with Parkinson's dementia

Galantamine (Razadyne)

 

Used to prevent or slow the symptoms of AD.
• loses its effect over time
• used for mild to moderate AD
• comes in pill form or as a skin patch
• does not prevent or cure AD

* may provide some benefit for vascular dementias

Memantine (Namenda)

 

Used to delay or slow the symptoms of AD.
• loses its effect over time
• used for moderate to severe AD
• sometimes given with donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne)
• does not prevent or cure AD

Citalopram (Celexa)

 

Used to reduce depression and anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep

Sodium valproate (Depakote)

 

Used to treat severe aggression.
• also used to treat depression and anxiety

Mirtazepine (Remeron)

Used to reduce depression and anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep

Carbamazepine (Tegretol)

 

Used to treat seizures
• also used to treat depression and anxiety

Sertraline (Zoloft)

Used to reduce depression and anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep