Dementia has many causes, and is not reversible. Treatment for dementia depends on the cause. Most dementias are progressive. This means that they get worse over time. There are currently no treatments available that stop or reverse this process. There are medications that can help relieve the symptoms and possibly slow the progression.
Only a doctor can suggest what treatment options are best for you. The following are treatment options for some of the more common forms of dementia.
Alzheimer’s Disease (AD)
Alzheimer’s disease is the most common form of dementia. There are currently four medications that have been shown to provide some benefit in AD. The effectiveness of these medications varies from person to person. Over time, the effectiveness diminishes.
- donepezil (Aricept): FDA approved for mild, moderate, and severe AD symptoms; side effects include nausea, vomiting, and diarrhea.
- galantamine (Razadyne): FDA approved for mild and moderate AD symptoms; side effects include nausea, vomiting, diarrhea, weight loss, and loss of appetite.
- memantine (Namenda): FDA approved for moderate and severe AD symptoms, but not for mild AD symptoms; side effects include dizziness, headache, constipation, and confusion.
- rivastigmine (Exelon): FDA approved for mild and moderate AD symptoms; side effects include nausea, vomiting, diarrhea, weight loss, loss of appetite, and muscle weakness.
There is no standard drug treatment for vascular dementia. Some of the symptoms, such as depression, can be treated. Most other vascular dementia treatments aim to minimize further vascular insults and thus prevent ongoing brain damage.
Studies suggest that some medications used for Alzheimer’s disease can also help with early vascular dementia.
The progression of vascular dementia can often be slowed or even halted if the underlying vascular risk factors for the disease are treated early enough.
For example, to help prevent strokes, doctors may prescribe medicines to control high blood pressure, high cholesterol, heart disease, and diabetes. To help prevent clots from forming in small blood vessels, doctors sometimes prescribe aspirin, warfarin, or other drugs. When patients have existing blockages in blood vessels, doctors may recommend surgical procedures to restore the normal blood supply.
In order to relieve restlessness, depression, or to help patients sleep better, doctors have a wide variety of medications from which to choose.
Frontal Lobe Dementia (FTD)
At present, no medications are approved specifically to treat or prevent FTD and most other types of progressive dementia. However, antidepressants and other medications may be useful in treating specific symptoms and behavioral problems associated with these diseases.
Lewy Body Dementia(LBD)
Current treatment for LBD focuses on symptom relief. This often involves the use of medication to control the psychiatric and Parkinson’s-like symptoms. However, while antiparkinson medication may help reduce tremors and loss of muscle movement, it can also worsen symptoms such as hallucinations and delusions. Conversely, some drugs prescribed for psychiatric symptoms may make the movement problems worse.
Additional medications may be used to treat some of the other symptoms often associated with dementia.
- citalopram (Celexa): reduces depression and anxiety, sometimes used as a sleep aid, may take four to six weeks to work
- valproate (Depakote): treats severe aggression, also used for depression and anxiety
- mirtazepine (Remeron): reduces depression and anxiety, may take four to six weeks to work, also used as a sleep aid
- carbamazepine (Tegretol): treats seizures, also used for depression and anxiety
- sertraline (Zoloft): reduces depression and anxiety, may take four to six weeks to work, sometimes used as a sleep aid
In order to control behavior problems associated with loss of judgment, impulsivity, and confusion, the following drugs may be prescribed:
- antipsychotics, such as haloperidol, risperidone, or olanzapine
- antidepressants such as fluoxetine or imipramine
- stimulants, such as methylphenidate