What Antipsychotics Can Help Treat Alzheimer's Symptoms?

Although cognitive issues are the hallmark of Alzheimer’s disease, there are other symptoms that may arise that are just as important to address, especially any symptoms of psychosis. Managing behavioral symptoms cannot only ease symptoms for the individual, but it can also make a difference in their relationships with family members and make caregiving easier as well.

Behavioral symptoms commonly seen in those with Alzheimer’s can include anxiety, aggression or agitation, hallucinations, restlessness, wandering, sleeplessness, and depression.¹

Managing neuropsychiatric symptoms

It is estimated that up to 90 percent of dementia patients will develop what are called neuropsychiatric symptoms, including delusions, hallucinations, aggressiveness, agitation, and delirium.² These symptoms can hasten functional decline, warrant inpatient hospitalization, and place significant stress on caregivers. While these symptoms are serious, treatment should be used thoughtfully.

Side effects of medications for these symptoms, like antipsychotics, can be severe and include increased risk of stroke and death.¹ These drugs can also bring out problems in movement especially in patients who are misdiagnosed. For example, antipsychotics can impair movement and cause rigidity and falling in patients with Lewy body dementia or Parkinson’s disease dementia. Other kinds of treatment should be done first, and medication used only in severe circumstances or if other treatments are not effective. It is critical to see a neurologist that specializes in memory disorders, and/or a geriatrician.

Potential antipsychotic medications

There are various kinds of antipsychotic medications that help to treat psychosis. Psychosis is a general term that describes a situation where reality has been distorted in some way and may include hallucinations (hearing or seeing things that aren’t there) or delusions (false beliefs).³ Sometimes this may be accompanied by agitation or aggression. Antipsychotics do not cure psychosis; they merely relieve the symptoms.

Older antipsychotics are often referred to as “typical” antipsychotics or “neuroleptics,” and include³:

• Chlorpromazine (Thorazine)
• Haloperidol (Haldol)
• Perphenazine (Trilafon)
• Fluphenazine (Prolixin)

Newer antipsychotic medications may also be called “atypical” antipsychotics and include³:

• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Aripiprazole (Abilify)
• Ziprasidone (Geodon)
• Paliperidone (Invega)
• Lurasidone (Latuda)

In treating psychotic symptoms in people with Alzheimer’s disease, atypical agents may be more effective than typical antipsychotics.³ Talk with a doctor to find out more about each drug and which one may be most appropriate, given any other medication that is being taken and what the specific situation calls for.

Side effects of antipsychotics

When taking any medication or supplement, there is always the risk of side effects. Sometimes these side effects dissipate as the body gets used to them, but sometimes they can be bothersome enough to warrant stopping the drug, reducing the dosage, or switching to a different one. Different drugs can have different side effects on each person, so if one doesn’t work for someone, talk with a doctor about trying another one.

Side effects of antipsychotics can include³:

• Drowsiness/fatigue
• Constipation
• Nausea or vomiting
• Blurred vision
• Low blood pressure
• Uncontrollable movements like tics or tremors
• Seizures
• Weight gain
• Restlessness
• Dizziness
• Dry mouth
• Increased risk of infections due to lowered white blood cell count

These are not all the possible side effects of antipsychotics. Patients should talk to their doctor about what to expect with treatment with antipsychotics.

Atypical antipsychotics may also require monitoring of weight, immune system function, and glucose and lipid levels.³

Talk with your doctor

Antipsychotic medications, while helpful for those with Alzheimer’s disease who are exhibiting certain symptoms, should not be the first-line treatment. When necessary, they should be used with care and carefully monitored for any adverse effects, drug interactions, or significant effects on the individual and their daily activities. Talk with the doctor about whether antipsychotics might be an option to treat any behavioral symptoms that are present.