Treatment for Dementia

A range of Alzheimer’s drug treatments can help some people. They do not cure dementia but can help with some of the symptoms. For some people, the drugs can help to slow down the progression of the dementia for some time. These treatments are not successful for everyone, so discussing all options with your doctor is essential.

The main drug treatments for Alzheimer’s disease are:

• Donepezil (Aricept)
• Rivastigmine (Exelon)
• Galantamine (Cognex)
• Memantine (Namenda)

Generally, donepezil, rivastigmine and galantamine are used for people with mild to moderate Alzheimer’s disease. Memantine is usually prescribed to people in the middle to later stages of the disease. These are the chemical names for these drugs; the prescription may have a trading name also on the script. The drug trade names are listed above in brackets alongside the chemical name. Ask the doctor if you are unsure. These drugs may also be used for people with Lewy body dementia and, in some cases, for people with vascular dementia.

People with vascular dementia often need to take medications for underlying conditions such as stroke, high blood pressure, diabetes, high cholesterol or heart problems. Controlling these conditions and adopting a healthy lifestyle by not smoking, drinking only in moderation, taking regular exercise and eating a balanced diet may help to delay the progression of this dementia.

People with dementia may be prescribed a range of medications to help relieve behavioural symptoms and depression. These medications can include

• sleeping tablets
• tranquillisers
• anti-anxiety drugs
• antipsychotic drugs
• anti-depressants

Not every person with dementia will need these medications; other methods exist to help manage these symptoms. Some people may need medication for a short period.

A decision to prescribe these medications should involve a full assessment of the person with dementia, their physical health and well-being. A Psychiatrist of Old Age may be introduced to carry out this assessment and help manage the symptoms. Areas such as unrecognised pain, eyesight, hearing and dental health should be explored to see if there are any other causes for the behaviour. It may be possible that the behaviour results from something in the environment triggering a response.

Talk to the doctor about daily routines, likes and dislikes so they can build a complete picture and help identify what triggers the behaviour. There are many ways to manage symptoms and behaviours that may emerge, and medication is one option that may or may not be suitable.

With all medication, it is important to understand what drugs are being prescribed, why they are being prescribed, what benefits they are supposed to bring, and what side-effects may emerge. Where possible, it is important for the person with dementia and a trusted person to discuss this with the prescribing doctor.

If a person with dementia is unable to participate in a discussion about medication, it is vital that their family or carer understand what is being prescribed and why. Talk to the doctors and ask questions. Ask them to provide information about the medications and to write out dosages and times to take them. It is also important to give doctors feedback on any changes experienced when taking the medication, both positive and negative.

You can talk to your doctor or pharmacist about issues that may arise.  Your pharmacist may be able to provide the medications in a blister pack or a medication box which arranges medication by day and time or log onto www.dontforget.ie. Building a relationship with a pharmacist can be helpful.

It may also be helpful for another family member or friend to know the medication routine and the name of the doctor and pharmacist you work with. The HSE have created a leaflet for people to fill in what medication they are on. You can bring this to any medical  appointments you may have. You can view the leaflet HERE