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Medications to Treat Cognitive Symptoms of Alzheimer's Disease

Reviewed by: HU Medical Review Board | Last reviewed: June 2022

Alzheimer's disease is an irreversible brain disorder that progressively impairs memory and cognition. It causes "plaques" and "tangles" in the brain, as well as nerve cell death and impaired nerve cell communication.1

Treatment for Alzheimer's disease involves many different therapies, including medicine. The goals of treatment include:

Different medicines are used during different stages of Alzheimer's. Many of these medicines are most effective in the early or middle stages of Alzheimer's. While these medicines can help slow down the progression of cognitive symptoms, they do not prevent Alzheimer's disease from getting worse.

Types of Alzheimer's medications

Several different types of medicines are approved to treat the cognitive symptoms of Alzheimer's disease.

To treat the cognitive symptoms of Alzheimer's disease, the FDA has approved the following medications:3

Cholinesterase inhibitors

Cholinesterase inhibitors are most effective in early to moderate Alzheimer's because they help to slow down or stop the breakdown of a chemical called acetylcholine, which helps cell communication and aids in memory and cognition.2 These medications are less effective as Alzheimer's disease becomes more widespread because as the condition progresses, there is less acetylcholine produced in the brain, so inhibiting the breakdown of acetylcholine does not have as much an effect.

Cholinesterase inhibitors include:

  • Donepezil (Aricept)
  • Galantamine (Razadyne)
  • Rivastigmine (Exelon)

These are all prescription-only drugs. People with Alzheimer's might respond better to one medication versus another, so if one drug is not effective, don't give up hope.

Memantine

Memantine (Namenda) is usually prescribed for moderate to severe Alzheimer's disease. Memantine works on glutamate, which is a chemical involved in information processing. Memantine can help to regulate glutamate, which helps to reduce symptoms.

Memantine + donepezil

Namzaric is a combination of donepezil, a cholinesterase inhibitor, and memantine, an NMDA antagonist. This medication is also usually prescribed for moderate to severe Alzheimer's disease.

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking

Some of the common side effects from these drugs for Alzheimer's include nausea, vomiting, changes in appetite (usually loss of appetite), increased bowel movements, constipation, and headache.2,3 Many of the side effects will resolve over time, but patients should let their doctor know about any side effects or abnormal symptoms that they may be experiencing.

Other things to know

Medications are just one part of treatment for Alzheimer's disease, but can be an important aspect of treating the condition. Some other medications may be used to treat behavioral aspects of Alzheimer's disease, such as antidepressants, but should be used with caution. This is especially true of medications used to address cognitive symptoms because some of those drugs may make cognitive symptoms worse. Talk with the doctor about whether medication is appropriate and safe, and if so, which one might be best.

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