By National Institute on Aging| Last Updated
An early, accurate diagnosis of Alzheimer’s disease (AD) helps patients and their families plan for the future. It gives them time to discuss care options, make financial decisions and complete important legal documents while the patient is still competent and able to participate in these vital processes.
Although no treatment has been proven to stop or slow the progression of AD, some prescription drugs have been shown to help minimize behavioral symptoms for some patients over a limited period of time. Some nonprescription treatments have also shown varying levels of promise in the fight against this neurodegenerative condition. Regardless, early diagnosis offers the best chance of finding an effective regimen that works for the patient for as long as possible.
Prescription Medications Used to Treat Alzheimer’s Disease
AgingCare.com has gathered information from the Alzheimer’s Association and the National Institute on Aging regarding drugs that are approved by the FDA to treat AD.
Medications for Early to Moderate AD
Cholinesterase inhibitors treat memory problems, thinking, language, judgment and other thought processes. This class of drugs prevents the breakdown of acetylcholine, a brain chemical believed to be important in memory function and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine, therefore cholinesterase inhibitors may eventually lose their therapeutic effect. Commonly used drugs include donepezil, rivastigmine and galantamine. All three of these work in the same way, but everyone reacts differently to medications, so one type may be more effective for a particular person than the others.
- Donepezil was originally patented as the brand name Aricept but is more widely available now as a generic.
- Rivastigmine was created as Exelon and is now also available under other brand names as well as in generic form.
- Galantamine is now available as a generic and under the brand names Nivalin, Razadyne, Reminyl, Lycoremine, Acumor, Galsya and Gatalin.
Medications for Moderate to Severe AD
The memantine class of drugs helps to improve memory, attention, reason, language and the ability to perform simple tasks. Memantine regulates the activity of glutamate, a messenger chemical involved in learning and memory. It may allow people with AD to maintain daily functions a little longer than they would without the medication. It was originally patented as Ebixa but is now available in generic form and under the popular brand name Namenda.
Medication Selection and Titration
These drugs can be taken without many side effects, but every patient metabolizes medications differently. Not everyone experiences the same effects or for the same length of time. It is also worth noting that different types of dementia respond better to certain kinds of drugs as well. Ask your physician what they would recommend for your loved one and what improvements as well as side effects to expect.
Research Into New Treatments for Alzheimer’s
The National Institute on Aging (NIA), part of the National Institutes of Health (NIH), is the lead federal agency for AD research. In addition to testing memory-related drugs, NIA-supported scientists are also testing vitamins, minerals and other classes of medications to see if they prevent AD, slow the disease or help reduce symptoms. Unfortunately, some ideas that seem promising turn out to have little or no benefit when they are carefully studied in a clinical trial.
The Effectiveness of Antioxidants Against AD
During the past several years, scientists have focused on a type of memory change called mild cognitive impairment (MCI), which is different from both AD and normal age-related memory changes. People with MCI have ongoing memory problems, but they do not have other losses such as confusion, attention problems and difficulty with language. The NIA-funded Memory Impairment Study compared donepezil, the antioxidant vitamin E and placebo in participants with MCI to see whether the drugs might delay or prevent progression to AD.
The study found that the group with MCI taking the drug donepezil were at reduced risk of progressing to AD for the first 18 months of a three-year study when compared with their counterparts on placebo. The reduced risk of progressing from MCI to AD among participants on donepezil disappeared after this 18-month period, and by the end of the study, the probability of progressing to AD was the same in the two groups. Vitamin E had no effect at any time point in the study when compared with placebo.
Other studies have shown that vitamin E may be beneficial in slowing the progression of the disease, but overall, results are still largely inconclusive. Additional studies are investigating whether other antioxidants like vitamin C might be effective.
The Connection Between Inflammation and AD
There is evidence that inflammation in the brain may contribute to AD damage. Some studies have suggested that drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) might help slow the progression of AD, but clinical trials thus far have not demonstrated a benefit from these drugs.
A clinical trial studying two of these medications, rofecoxib (Vioxx) and naproxen (Aleve), showed that they did not delay the progression of AD in people who already have the disease. Another trial, testing whether the NSAIDs celecoxib (Celebrex) and naproxen could prevent AD in healthy older people at risk of the disease, has been suspended. However, investigators are continuing to follow the participants and are examining data regarding possible cardiovascular risk. Researchers are continuing to look for ways to test how other anti-inflammatory drugs might affect the development or progression of AD.