Can dementia be treated?
There are several different medications that can be used to treat Alzheimer’s and other forms of dementia. The drugs available don’t yet offer a cure but they can help to slow the disease progression down. These are the essential facts you need to know about the dementia treatment and what’s available
In a nutshell
Drug treatments are an important way to help someone with dementia live well. A drug treatment for dementia is designed to ease symptoms such as memory loss, behavioural and psychological problems, hallucinations and insomnia. But they don’t work for everyone, and should be regarded as one of many ways to help manage dementia alongside other therapies and lifestyle changes.
Drugs for Alzheimer’s
Name: The three drugs commonly used to slow down the progression of Alzheimer’s are called Donepezil (although you might know it by its original brand name Aricept), Rivastigimine (Exelon) and Galantamine (Reminyl). As a group, these drugs are called Acetylcholinesterase inhibitors.
When they’re used: These are usually prescribed for mild to moderate Alzheimer’s and can help to improve memory and concentration.
Side effects: Nausea and vomiting but this should settle down within a couple of weeks.
Name: Memantine (you might know it as Exiba)
When it’s used: This is prescribed for people in the moderate to late stages of Alzheimer’s disease and can help to alleviate distressing symptoms such as delusions and disorientation.
Side effects: Dizziness, tiredness, headaches, constipation,
How to get them
All the drugs above have to be prescribed by a doctor or consultant after a detailed medical assessment. The Alzheimer’s drugs are usually only given for between 6-12 months as research suggests their effect seems to wear off after that. Since Donepezil (Aricept) is the least expensive to prescribe, you may be offered that first.
Did you know? Alzheimer’s drugs have been shown to help around 40-70 per cent of people with the disease.
In the pipeline…
Two hundred people in the early stages of Alzheimer’s have been recruited to take part in a year long £5m clinical trial into a new drug which could have the potential to prevent Alzheimer’s. The drug, called Liraglutide is currently used to treat diabetes but was shown in research to reverse memory loss in mice with late-stage Alzheimer’s.
If the trial is successful, the drug could be on offer within five years.
Drugs for other forms of dementia
The Alzheimer’s drugs above can be prescribed for other forms of dementia, but not always. Here’s a rough guide to the sort of medication you might be offered if you have a different type of dementia.
The Alzheimer’s drugs aren’t generally seen as being effective for vascular dementia, though some studies suggest they might help people in the early stages. So if you aren’t offered them, it’s worth asking why not. (You could ask for a second opinion if you still aren’t satisfied).
Since vascular dementia is often linked to strokes, medications which help improve lifestyle (and reduce the risk of any further strokes) are usually recommended and can really help to slow down the progression of vascular dementia. These include:
– Drugs to lower blood pressure (called ACE inhibitors or beta-blockers)
– Statins to lower cholesterol
– Asprin or anticoagulants such as warfarin to prevent blood clots and further strokes.
Dementia with Lewy bodies
Studies show that people with dementia with Lewy bodies or mixed dementia (when Alzheimer’s is the main cause) can benefit from the Alzheimer’s drugs and may be offered them.
Frontotemporal dementia (Pick’s disease)
The Alzheimer’s drugs don’t, unfortunately, seem to help people with frontotemporal dementia (sometimes called Pick’s disease), but antidepressants (see below) have been found to help ease some of the behaviour problems related to it.
Other drugs people with dementia might be given
Drugs to lift mood
It’s quite common for people with dementia to have depression as well (which might make their memory worse) and anti-depressants can be effective, although evidence is still patchy. The most widely prescribed are called selective serotonin reuptake inhibitors (SSRIs), best known are fluoxetine (Prozac) citalopram (Cipramil) paroxetine (Seroxat) and sertraline (Lustral). Newer drugs called selective norepinephrine reuptake inhibitor (SSNR’s) can also be effective include drugs such as venlafaxine (Effexor). However, all of these drugs take several weeks (around 4- 6 weeks normally) to work.
Side effects: Usually mild, but include nausea, a dry mouth, insomnia and agitation.
Warning: Older antidepressants (including tricyclic antidepressants) can worsen memory problems in people with dementia.
Drugs to help sleep
If the person you’re caring for seems permanently exhausted due to disrupted sleep sleeping pills can be prescribed. Although studies have shown that older style benzodiazepine sleeping pills may increase the risk of developing dementia, the newer drugs, known as ‘Z drugs’ ( such as zolpiderm or zopiclone) aren’t thought to carry the same risk.
Side effects: These are commonly prescribed and shouldn’t cause drowsiness or other unpleasant side effects.
Warning: Consult your doctor before taking regular, high doses of hay fever medication or over- the-counter sleep remedies containing antihistamines. Recent US research suggests these drugs may also slightly increase your risk of developing dementia.
Drugs to treat psychological and behavioural symptoms
These are called anti-psychotics, and are the same drugs used to treat people with mental health conditions such as schizophrenia. Only one – Risperidone – is licensed for the treatment of dementia and research suggests that it should be used very cautiously for someone with dementia as potential side-effects can be dangerous.
Good to know
Lots of research into new drug treatments for dementia is happening now. It’s quite possible that drugs which give better relief from symptoms, or that help to prevent it, could be available during your lifetime.
To find out more, or to get on a clinical trial, go here.