Alzheimer’s Disease Medications
FACT SHEET
Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. It is important to understand that none of these medications stops the disease itself.
Treatment for Mild to Moderate Alzheimer’s Medications called cholinesterase inhibi- tors are prescribed for mild to moderate Alzheimer’s disease. These drugs may help delay or prevent symptoms from becoming worse for a limited time and may help control some behavioral symp- toms. The medications include Razadyne® (galantamine), Exelon® (rivastigmine), and Aricept® (donepezil).
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the break- down of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.
No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not pro- duce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.
Treatment for Moderate to Severe Alzheimer’s A medication known as Namenda® (memantine), an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer’s disease. This drug’s main effect is to delay pro- gression of some of the symptoms of moderate to severe Alzheimer’s. It may allow patients to maintain certain daily functions a little longer than they would without the medication. For example, Namenda® may help a patient in the later stages of the disease maintain his or her ability to use the bathroom inde- pendently for several more months, a benefit for both patients and caregivers.
The FDA has also approved Aricept® and Namzaric®, a combination of Namenda® and donepezil, for the treatment of moderate to severe Alzheimer’s disease.
Namenda® is believed to work by regu- lating glutamate, an important brain chemical. When produced in excessive
amounts, glutamate may lead to brain cell death. Because NMDA antagonists work very differently from cholinester- ase inhibitors, the two types of drugs can be prescribed in combination.
Dosage and Side Effects
Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evi- dence that certain patients may benefit from higher doses of the cholinesterase inhibitors. However, the higher the dose, the more likely are side effects. The recommended effective dosages of drugs prescribed to treat the symptoms of Alzheimer’s and the drugs’ possible side effects are summarized in the table (see inside).
Patients should be monitored when a drug is started. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.
Testing New Alzheimer’s Drugs
Clinical trials are the best way to find out if promising new treatments are safe and effective in humans. Volunteers are needed for many Alzheimer’s trials conducted around the United States. To learn more, talk with your doctor or visit the ADEAR Center’s listing of clinical trials at www.nia.nih.gov/alzheimers/clinical- trials. More information is available at www.nia.nih.gov/alzheimers/volunteer.
For More Information
To learn about support groups, research centers, research studies, and publica- tions about Alzheimer’s disease, contact the following resources:
Alzheimer’s Disease Education and Referral (ADEAR) Center 1-800-438-4380 (toll-free) [email protected] www.nia.nih.gov/alzheimers
The National Institute on Aging’s ADEAR Center offers information and publications for families, caregivers, and professionals on diagnosis, treatment, patient care, caregiver needs, long-term care, education, training, and research related to Alzheimer’s disease. Staff members answer telephone, email, and written requests and make referrals to local and national resources. Visit the ADEAR website to learn more about Alzheimer’s and other dementias, find clinical trials, and sign up for email alerts.
Alzheimer’s Association
1-800-272-3900 (toll-free) 1-866-403-3073 (TTY/toll-free) [email protected]
www.alz.org
Alzheimer’s Foundation of America
1-866-232-8484 (toll-free) [email protected] www.alzfdn.org
