Common Treatments for Alzheimer's and its Symptoms

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Currently, there is no cure for Alzheimer's disease (AD). However, there are medications that can help control its symptoms. In addition, treatments are also available to help manage agitation, depression or psychotic symptoms (hallucinations or delusions) which may occur as the disease progresses. Consult a physician before taking any medications.

In this section, you will find information on:

* Cholinesterase Inhibitors
* Namenda
* Treatment for Anxiety, Depression and Psychosis

Cholinesterase Inhibitors

Although there is no cure for Alzheimer’s disease (AD), there are four drugs, called cholinesterase inhibitors, approved by the Food and Drug Administration (FDA) that are designed to regulate its symptoms and delay its course. Those suffering from AD have low levels of acetylcholine, an important brain chemical involved in nerve cell communication. Cholinesterase inhibitors slow the metabolic breakdown of acetylcholine, and make more of this chemical available for communication between cells. This helps slow the progression of cognitive impairment and can be effective for some patients in the early to middle stages of AD.

All four treatments are approved for mild to moderate symptoms of AD. In 2006, one of the treatments, Aricept®, was approved by the FDA for the management of severe AD symptoms. The four FDA-approved cholinesterase inhibitors are:

* Razadyne® (galantamine)
* Exelon® (rivastigmine)
* Aricept® (donepezil)
* Cognex® (tacrine)

Razadyne®

Generic name: galantamine
Year approved by the FDA: 2001
Effective for: Early to moderate Alzheimer’s disease
How it works: Razadyne® prevents the breakdown of acetylcholine and stimulates nicotinic receptors to release more acetylcholine in the brain.
Most common side effects: Nausea, vomiting, diarrhea, weight loss
Miscellaneous: This medication was formerly known as Reminyl®.

Exelon®

Generic name: rivastigmine
Year approved by the FDA: 2000
Effective for: Early to moderate Alzheimer’s disease
How it works: Exelon® prevents the breakdown of acetylcholine and butyrylcholine (a chemical similar to acetylcholine) in the brain.
Most common side effects: Nausea, vomiting, weight loss, upset stomach, weakness
Miscellaneous: In 2007, the FDA approved the Exelon®Patch (rivastigmine transdermal system) to deliver this medication through a skin patch as an option to the oral capsule.

Aricept®

Generic name: donepezil
Year approved by the FDA: 1996
Effective for: Early, moderate and severe Alzheimer’s disease
How it works: Aricept® prevents the breakdown of acetylcholine in the brain.
Most common side effects: Nausea, diarrhea, vomiting
Miscellaneous: Aricept may also have a limited slowing effect on the progression from mild cognitive impairment (MCI) to AD. Study results published in April 2005 by the New England Journal of Medicine indicated that over the first year of a three-year trial, those with MCI treated with Aricept had a reduced risk of progressing to AD compared to participants who took vitamin E or a placebo (an inactive pill). However, by the end of the study, there was no difference among the three groups except for those with the ApoE4 gene. Aricept’s effect lasted up to two to three years for these participants. Previous studies have indicated those with the ApoE4 gene have a higher chance of developing AD than the general population.

Cognex®

Generic name: tacrine
Year Approved by the FDA: 1993 (Cognex is still available but no longer actively marketed by the manufacturer, due to the severe side effects.)
Effective for: Early to moderate Alzheimer’s disease
How it works: Cognex prevents the breakdown of acetylcholine in the brain.
Most common side effects: Nausea, diarrhea, possible liver damage



Namenda®

Namenda® (memantine) was the first drug approved by the FDA to treat the symptoms of moderate to severe Alzheimer’s disease (AD). It appears to protect the brain's nerve cells against excess amounts of glutamate, a messenger chemical released in large amounts by cells damaged by AD (and some other neurological disorders). When glutamate attaches to cell surface "docking sites" called N-methyl-D-aspartate (NMDA) receptors, this permits calcium to flow freely into the cell, which in turn may lead to cell degeneration. Namenda may prevent this destructive sequence by adjusting the activity of glutamate. For many years, Namenda was available in some European countries to treat moderate to severe AD, and it has been available in the U.S. since October 2003. Namenda is generally well-tolerated; the most common side effects are dizziness, confusion, headache and constipation.


Treatment for Anxiety, Depression and Psychosis

Often, as Alzheimer’s disease progresses, people experience depression, agitation and psychotic symptoms (paranoid thoughts, delusions or hallucinations).These behaviors may be manifested verbally (screaming, repetitive questions, etc.) or physically (hoarding, pacing, etc.), and they can sometimes lead to aggression, hyperactivity or combativeness. The symptoms may have an underlying medical origin such as a drug interaction or physical pain, and if this is a suspected cause a physician should be consulted. Agitation or psychotic behavior may also be triggered by something different in the person’s environment. Often, a change in routine, caregivers or surroundings can cause fear, anxiety or fatigue and lead to agitation. The individual may be unable to communicate, be frustrated by his or her limitations, misunderstand what is happening or simply forget how to respond appropriately. In these cases, non-medical intervention is recommended to determine the source of the problem, modify the environment and change the behavior. If non-medical intervention does not work or the person becomes a danger to himself or others, a physician should be consulted to evaluate the need for medical treatments for depression, psychosis or anxiety.


Disclaimer: The information provided in this section is a public service of the American Health Assistance Foundation, and should not in any way substitute for the advice of a qualified healthcare professional and is not intended to constitute medical advice. Although we take efforts to keep the medical information on our website updated, we cannot guarantee that the information on our website reflects the most up-to-date research. Please consult your physician for personalized medical advice; all medications and supplements should only be taken under medical supervision. The American Health Assistance Foundation does not endorse any medical product or therapy.

Source: The information provided in this section of our website was obtained from the National Institute on Aging, the Mayo Clinic and Clinical Trials.gov. Information on Aricept was obtained from the National Library of Medicine, the Food and Drug Administration, Eisai Inc., Pfizer Inc., and the American Health Assistance Foundation.

Last Reviewed On: 01/07/09