Drugs Used In Dementia Care

Most dementias are progressive, so the symptoms will gradually get worse over time. Although there is no cure, there are dementia drugs available for the treatment of progressive dementia. The type of drugs used fall into two categories:

  • Anti dementia drugs which may temporarily slow the progression of the disease and improve the symptoms of dementia such as memory and concentration.
  • Behavioural and psychological drugs which are used to treat the associated symptoms of dementia such as depression and sleep disturbances.

Anti dementia drugs

Dementia drugs
How do they work?

Cholinesterase inhibitors boost levels of a chemical call acetylcholine, involved in nerve cell communication.

For some these drugs lessen their symptoms for a while. Other benefits include reduced anxiety and improvements in motivation, memory, concentration and daily living.

When are they prescribed?

These drugs are licensed and recommended specifically for people with mild to moderate Alzheimer’s. Doctors may continue to prescribe one of these drugs for longer if they believe it is still having a beneficial effect.

Cholinesterase inhibitors are not usually beneficial for people with vascular dementia. However, they may be helpful for people with both Alzheimer’s and vascular dementia, also called ‘mixed dementia’.

There is evidence that cholinesterase inhibitors may help to improve some of the symptoms of dementia with Lewy bodies, including thinking skills and visual hallucinations.

Side effects?

The most common side effects of cholinesterase inhibitors are feeling or being sick, diarrhoea, having trouble sleeping, muscle cramps, and tiredness. These effects are often mild and usually only temporary. Not everyone will experience side effects.


Drugs used in dementia care

How do they work?

Memantine regulates the activity of glutamate another chemical messenger involved in brain functions such as learning and memory.

Memantine can temporarily slow down the progression of symptoms in people in mid/late stage of Alzheimer’s. It may also help with agitation or aggression, both more common in the later stages of the disease.

When are they prescribed?

Memantine is recommended as an option for people with severe Alzheimer’s disease, and for people with moderate Alzheimer’s if cholinesterase inhibitors don’t help or are not suitable. Memantine is currently only recommended for people with Alzheimer’s disease.

Side effects?

Some people experience side effects when taking memantine. The most common side effects of memantine are headaches, dizziness, drowsiness and constipation. These effects are usually only temporary.

Behavioural & psychological drugs

Drugs to treat dementia

Why are anti psychotic drugs prescribed and who can they help?

They are prescribed for behavioural and psychological symptoms in dementia. This is because in some cases they can eliminate or reduce the intensity of psychotic symptoms, such as delusions and hallucinations, and can have a calming and sedative effect.

However work is underway to reduce the use of anti psychotic drugs in dementia care as they are linked to serious side effects, only have a moderate short term benefit and do not address the underlying causes of behaviours such as agitation or aggression.

Antipsychotic drugs may be prescribed for people with Alzheimer’s disease, vascular dementia or mixed dementia. If a person with Lewy body dementia must be prescribed an antipsychotic drug, it should be done with the utmost care, under constant supervision, and should be regularly reviewed. This is because people with Lewy body dementia, who often have visual hallucinations, are at particular risk of severe adverse reactions.

Source of information Alzheimer’s Research UK who have produced a very helpful booklet about the treatments available for dementia.