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Medications for Alzheimer Disease

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

There are no medications to cure Alzheimer disease, but certain medications are commonly prescribed to manage the symptoms. Other medications are under investigation in clinical trials.

Prescription Medications

Prescription Medications

 

Cholinesterase Inhibitors

Cholinesterase inhibitors most commonly prescribed for Alzheimer disease include:

  • Donepezil
  • Rivastigmine
  • Galantamine

Cholinesterase inhibitors help enhance memory and other cognitive functions. This type of medication slows the breakdown of a chemical that helps cells communicate with one another. The longer this chemical exists the better the communication between brain cells. This may help to slow disease progression somewhat in people with mild-to-moderate Alzheimer disease.

Depending on which cholinesterase inhibitor you take, possible side effects include:

  • Nausea, vomiting
  • Diarrhea
  • Stomach pain or cramping
  • Slowing of heart rate
  • Fainting spells
  • Headache
  • Loss of appetite
  • Increased frequency of bowel movements
  • Liver problems (especially with tacrine)
  • Rashes
  • Lightheadedness
  • Nasal discharge
  • Facial flushing
 

Glutamate Blockers

Memantine is a newer type of medication. It blocks the effects of a chemical that is believed to be toxic to nerve cells. Memantine is the first drug approved for treatment of moderate-to-severe Alzheimer disease. Improvements in daily functioning and cognition (thinking) have been seen. Memantine should not be used if you have severe kidney impairment.

Possible side effects of memantine include:

 

Antidepressants

At least 25% of people with Alzheimer disease have depression. Antidepressants are used to treat low mood, depression, anxiety, and irritability. The antidepressants prescribed for Alzheimer disease belong to a group of medications known as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the activity of the chemical serotonin in the brain.

SSRIs prescribed for Alzheimer disease include:

  • Citalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline

Possible side effects of SSRIs include:

  • Drowsiness
  • Dryness of mouth
  • Blurred vision
  • Nausea
  • Lightheadedness
  • Weight gain
  • Difficulty sleeping
  • Sexual dysfunction
  • Risk of severe mood and behavior changes, including suicidal thoughts in some
 

Anti-anxiety Medications

Anti-anxiety medications (anxiolytics) help ease symptoms of anxiety, phobias, and excessive motor activity. The medications listed are in a class of medications called benzodiazepines. Benzodiazepines reduce symptoms of anxiety by enhancing the function of gamma aminobutyric acid (GABA). These drugs produce a sedative effect, decrease physical symptoms, such as muscle tension, and often cause drowsiness and lethargy. They can be habit-forming when used long term or in excess. These drugs should not be used more than prescribed since they may cause or worsen problems with memory. These drugs should also not be stopped abruptly since serious side effects, such as seizures, may result.

Benzodiazepines sometimes prescribed for Alzheimer disease include:

  • Lorazepam
  • Oxazepam

Possible side effects of benzodiazepines include:

  • Drowsiness
  • Lightheadedness
  • Confusion
  • Weakness
  • Difficulty walking
  • Respiratory depression (decreasing breathing)
 

Antipsychotics

Antipsychotic medications are used for symptoms of agitation, hallucinations, delusions, bizarre behavior, and violent behavior. These drugs usually have a sedating effect on behavior and may not always be effective for those with Alzheimer disease.

Antipsychotics sometimes prescribed for Alzheimer disease include:

  • Olanzapine
  • Risperidone
  • Quetiapine

Possible side effects of olanzapine include:

  • Agitation
  • Behavior problems
  • Difficulty in speaking or swallowing
  • Restlessness or need to keep moving
  • Stiffness of arms or legs
  • Trembling or shaking of hands and fingers

Possible side effects of risperidone and quetiapine include:

  • Tardive dyskinesia (fine, worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, shoulders, arms, or legs)

In some cases these side effects are not reversible.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.
REFERENCES:

Alzheimer dementia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia. Updated November 29, 2018. Accessed December 21, 2018.

Burns A. Alzheimer’s disease: on the verges of treatment and prevention. Lancet Neurology. 2009;8(1):4-5.

Neogroschul J, Sano M. Current treatment and recent clinical research in Alzheimer’s disease. Mt Sinai J Med. 2010;77(1):3-16.

Treatments. Alzheimer’s Association website. Available at: https://www.alz.org/alzheimers-dementia/treatments. Accessed December 21, 2018.

2/18/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T921683/Adverse-effects-of-antidepressant-medication: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

Last reviewed September 2018 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/29/2018