Anxiolytics for Alzheimer's Disease

Reviewed by: HU Medical Review Board | Last reviewed: January 2024 | Last updated: February 2024

While cognitive issues are the hallmark of Alzheimer’s disease, the condition often also causes behavioral changes. Managing behavioral symptoms can improve quality of life for the person with Alzheimer's, their family members, and caregivers.

Behavioral symptoms commonly seen in those with Alzheimer’s can include:1

Examples of anxiolytics for anxiety and agitation

Anxiety and agitation are not uncommon in Alzheimer’s disease. These feelings may be caused by a number of things, including other medical conditions, medicine or medicine interactions, or changes in a person’s daily routine.

Anxiolytics are drugs used to help treat anxiety and agitation. However, they can cause side effects like sleepiness, confusion, and dizziness. Anxiolytics can also increase a person's fall risk, so these drugs should only be used for short periods of time.1

There are other ways to help treat anxiety, including:2

  • Changes to a person's environment
  • Simplifying routines
  • Behavior modifications, like helping the person find an outlet for their energy, taking a walk with them, and providing reassurance and positive reinforcement

Common anxiolytics used to treat anxiety and agitation in people with Alzheimer's disease include:3

  • Clonazepam (Klonopin)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)

The most common kind of anxiolytics are benzodiazepines. In some cases, antidepressants like SSRIs can also be used to treat anxiety.3

Talk to a doctor about the specific anxiety or agitation that is happening. The doctor will be able to decide which medicine might be best for someone with Alzheimer’s based on their symptoms, other drugs they may be taking, and their general health and level of functioning.

What are the possible side effects?

Common side effects of anxiolytics can include:3

  • Drowsiness
  • Dizziness
  • Nausea
  • Blurry vision
  • Confusion
  • Nightmares
  • Headaches
  • Dependency

Older adults are more likely to have the following side effects of benzodiazepines:4

  • Confusion
  • Tiredness
  • Increased risk of falls and fractures
  • Impaired driving skills with increased crash risk
  • Increased risk of an emergency room visit

Benzodiazepines like clonazepam, alprazolam, and lorazepam have a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). They have this warning because they:5

  • Can lead to physical dependency
  • May cause dangerous withdrawal symptoms if the dose is suddenly withdrawn or reduced
  • Carry a risk of abuse, misuse, and addiction
  • Can have life-threatening side effects if taken with alcohol or opioids

These are not all the possible side effects of anxiolytics. Talk to your doctor about what to expect when taking anxiolytics. You also should call your doctor if you have any changes that concern you when taking anxiolytics.

Other things to know

Anxiolytics can be a helpful treatment for people with Alzheimer’s disease. But they should be prescribed with care and only after other kinds of treatment have proven ineffective.

Before beginning treatment for Alzheimer's disease, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.