Treatment for Dementia
Sadly there is no cure for dementia at the moment. However, some treatments can help. Drug treatments can be effective for some people, and a range of medications can help with some of the symptoms.
People with dementia can be prescribed a range of medications during the illness. Some are specifically for Alzheimer’s disease, and others are for symptoms that may emerge as part of dementia.
A range of Alzheimer’s drug treatments can help some people. They do not cure dementia but help with some of the symptoms. Some people can help to slow down the progression of dementia with these treatments 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 work 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 trade names for the drugs are listed above in brackets. 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.
Vascular dementia drugs
People with vascular dementia often need 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.
Drugs for behavioural symptoms and depression
People with dementia may be prescribed a range of medications to help relieve behavioural symptoms and depression. These medications can include
- sleeping tablets
- anti-anxiety drugs
- antipsychotic drugs
Not every person with dementia will need these medications; there are other methods 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 to identify what is triggering 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 you and a trusted person to discuss this with the prescribing doctor. In 2019 the Department of Health launched a national clinical guideline for the “appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia”. A guide for people with dementia was published and is available HERE
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. You can also get electronic blister packs, which are set to a timer, and only open up at certain times of the day. For more information contact your local Memory technology resource room. click HERE or you can contact our National Helpline on 1800 341 341 and our Helpline team can provide you with details of your local resource room.
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 write down what medication they are on You can bring this to any medical appointments you may have. You can view the leaflet HERE