How is Alzheimer's disease treated?

Dr. Jeanne Morrison, PhD
Family Practitioner

Currently, there are no medicines that can slow the progression of AD. However, four FDA-approved medications are used to treat symptoms of AD. These drugs help individuals carry out their daily activities by maintaining thinking, memory, or speaking skills. They can also help with some of the behavioral and personality changes associated with AD. However, they cannot stop or reverse AD and appear to help individuals for only a limited time. Donepezil (Aricept), Rivastigmine (Exelon), and Galantamine (Reminyl) are prescribed for mild to moderate AD symptoms. Donepezil was recently approved to treat severe AD as well. The newest AD medication, memantine (Namenda), has been prescribed for moderate to severe AD symptoms.

This information is based on source information from the National Institute of Neurological Disorders and Stroke.

There is no cure for Alzheimer's disease but there are treatment options that can help prolong brain function and slow the course of the disease. Medications called cholinesterase inhibitors (donepezil, galantamine and rivastigmine) can help improve memory and brain function by boosting the level of acetylcholine (a neurostransmitter that moves among brain cells carrying signals). Memantine, another medication, has shown promise in slowing the progression of the disease. Many treatments combine these drugs, but they don't work for everyone and some people opt not to take them because of the side effects, which include diarrhea, nausea, vomiting and dizziness.

There is no cure for Alzheimer's disease, but early diagnosis is important. Drugs are available that may temporarily stabilize or slow the progression of cognitive symptoms, such as reasoning or planning They work best in the early stages of the disease.

While there are no medical treatments that can reverse the effects of Alzheimer's disease or slow its progression, there are a handful of drugs approved by the U.S. Food and Drug Administration (FDA) that can alleviate some of the cognitive and behavioral symptoms in the disease's early or moderate stages. Medications also are available for other symptoms associated with Alzheimer's, such as agitation, delusions and depression. It's important for a healthcare professional to discuss some of the side effects of these drugs with you or the person you know who has Alzheimer's.

A healthy lifestyle is important for optimal treatment of Alzheimer's. This includes a well-rounded diet, treatment of medical conditions, regular physical activity sustained over 30 minutes, social engagement and encouraging participation in daily activities to the extent possible with existing impairments.

Whenever possible, healthcare professionals usually recommend nondrug options first to treat behavior disturbance—such as changing the mood of the person's home environment, creating a routine and staying active and keeping socially engaged -- since some medications can contribute to increased problems with dementia.

While Alzheimer's disease has no cure, there are medications that can help if they are administered during the early stages of the disease.

Drugs also may be used to treat symptoms such as depression, insomnia and anxiety, which often accompany Alzheimer's disease.

Medications also can be used to against potential infections.

One class of Alzheimer's drug is called Cholinesterase inhibitors, which includes donepezil, rivastigmine and galantamine. These drugs boost neurotransmitter levels. Memantine is only the approved drug for advanced Alzheimer's.

There is no cure for Alzheimer's disease today, and no way to reverse the deterioration it causes. Two kinds of medications are now available to treat the cognitive symptoms of Alzheimer's disease. In the early stage of the disease doctors may prescribe drugs called cholinesterase inhibitors (Aricept, Exelon, and Razadyne), which can delay the worsening of symptoms for several months in about half of the people. In patients with moderate to severe forms of the disease doctors may prescribe Namenda, a drug that regulates levels of glutamate in the brain, and which may delay the worsening of symptoms in some people. Other medications can help manage symptoms such as depression, behavioral disturbance, and sleeplessness.

New research findings give reason for hope, though, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.

There are two classes of drugs approved by the FDA for Alzheimer's disease: three are cholinesterase inhibitors, and one is an antagonist at glutamate receptors. The cholinesterase inhibitors (Aricept, also known as donepezil, Exelon, also known as rivastigmine, and Razadyne, also known as galantamine) are first line drugs used early in the disease, especially to help memory problems. The glutamate blocker Namenda, also known as memantine, is primarily used in the middle stage of the disease although there is some evidence that the drug may also work earlier on. That said, none of the drugs change disease progression, and there was an important study in the UK in 2005, showing that after 18 months of Alzheimer's, a group treated with donepezil was no better off than the control group that received a sugar pill.

The only readily available intervention that delays the onset and slows the progression of Alzheimer's disease is physical exercise. A minimum of three exercise sessions of 30 minutes each per week is the usual guideline. Recent studies show that genetic risks can be neutralized, or even reversed, by such an exercise program. When it comes to slowing progression, then, or to delaying or preventing Alzheimer's in the healthy, a regular exercise program is the most important intervention that I prescribe.

The goal of Alzheimer's treatment is to slow the progression of symptoms including mental function, memory and behavioral symptoms such as delusions, agitation and sleep disturbances. Medications that work by regulating neurotransmitters, the chemicals that transmit messages between neurons, have been shown to help with some Alzheimer's patients. Also, depending on the stage of the disease, there are also daily techniques such as ensuring the patient has a regular schedule, keeping things in the same places in the house and exposing the person to daylight. This can help reorient Alzheimer's patients and limit the amount of frustrations and hazards of having the disease.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.