How Is Alzheimer's Disease Treated?

Alzheimer's is a complex disease, and the treatment of Alzheimer's disease can also be complex. There is no cure for the disease. But, treatment may slow disease progression, manage symptoms, and help with memory and thinking. Treatment typically depends on the stage and symptoms.^1,2

Medicines to slow disease progression

Many Alzheimer's drugs just manage symptoms. But, drugs that slow disease progression aim to treat the underlying cause of Alzheimer's. Currently approved therapies that slow progression work by removing a protein called amyloid that builds up into plaques in the brain. Research suggests that this plaque buildup may be the root cause of the symptoms of Alzheimer's.^1,2

These drugs are called anti-amyloid drugs. They may not be right for everyone because they can cause serious side effects. Examples include:^1,2

• Donanemab (Kisunla™)
• Lecanemab (Leqembi^®)

Medicines to treat cognitive symptoms

Cognitive symptoms are often the symptoms we associate with Alzheimer’s. They include memory loss and thinking issues. There are 2 main types of drugs to treat cognitive symptoms:^1,2

• Cholinesterase inhibitors – These drugs prevent the breakdown of a chemical that helps with brain function. Examples are Donepezil (aricept®), rivastigmine (Exelon®), and galantamine (Razadyne®).
• Glutamate regulators – These drugs work by limiting the neurotransmitter glutamate in the brain, which impacts how the brain works. These drugs may also be called a N-methyl-D-aspartate (NMDA) antagonist. An example is Memantine (Namenda®).
• Combination drugs – These are a mix of a cholinesterase inhibitor and glutamate regulator. An example is donepezil and memantine (Namzaric®).

Medicines to treat behavioral symptoms

Some drugs can help manage the behavioral symptoms of Alzheimer’s. These might include aggression, aggravation, paranoia, or hallucinations. Drugs for these symptoms can include:^1-3

• Antidepressants – These drugs can help manage anger or irritation. The type of antidepressant most commonly used in people with Alzheimer's is called a selective serotonin reuptake inhibitor (SSRI).
• Anti-anxiety drugs – These can help treat agitation. Some types of anti-anxiety drugs may not be safe for people with Alzheimer’s.
• Anticonvulsant drugs – These drugs may help manage aggression.
• Antipsychotic drugs – These may be used to manage anger, paranoia, or hallucinations. People typically try other drugs before using antipsychotics. This is because they have a risk of serious side effects.
• Sleep aids – These drugs can help people fall asleep and stay asleep. But it may not be safe for someone with Alzheimer’s to use sleep aids regularly.

Therapy options

Several types of therapy may help people with Alzheimer’s. Therapy can help manage emotions, accomplish tasks, or improve behavior. Types of therapies for Alzheimer’s include:^4-6

• Cognitive therapy – May include activities or exercises that target brain function. For example, this could be practice with concentration, communication, or memory.
• Cognitive behavioral therapy (CBT) – A talk therapy that focuses on the link between thoughts, feelings, and behaviors. It can help treat depression and anxiety for people with Alzheimer’s.
• Occupational therapy – A type of therapy that helps people accomplish daily tasks. This can include working on strategies to make tasks easier. This can help with behavior issues and independence.

Complementary and alternative therapies

Complementary and alternative medicine (CAM) treatments are treatments that are outside of standard medical care. Examples could be vitamins, foods, or herbs. There is no research that proves that any CAM treatment can treat or prevent Alzheimer's. However, some limited studies have suggested that some CAM options may be helpful, including:^3,7

• Omega-3 fatty acids
• Huperzine A, a moss extract used in Chinese medicine
• Ginkgo biloba, a plant extract

Supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose. Some CAM treatments can interfere with prescribed medicines. Talk with your doctor before starting a new CAM treatment.^3,7

Research also suggests that exercise can help slow progression of the disease. Healthy nutrition is another important factor, since people with Alzheimer's might forget to eat or drink, or they may have a reduced appetite.^3,8

Treatments on the horizon

Researchers are studying new drugs and medical devices for Alzheimer’s disease. Many of them target the changes that occur in the brain to slow or stop them.⁹

Clinical trials are an important part of this research. These studies need volunteers with and without Alzheimer’s disease. If you are interested in participating, talk to your doctor or visit the Alzheimer’s Association TrialMatch website.⁹