There are several medications used to treat the symptoms of Alzheimer's. Unfortunately, no medication has yet been developed to stop the disease from progressing. All current, available medications work by improving cognitive and behavioral symptoms in Alzheimer's Disease.

Acetylcholinesterase Inhibitors

These medications are the only currently FDA approved medications for the treatment of the symptoms of Alzheimer's Disease. Brain cells (neurons) in a part of the brain called the the medial basal forenbrain area are among the first to be affected by Alzheimer's Disease. The cells in this area release a chemical transmitter called acetylcholine. Acetylcholinesterase inhibitors work by increasing the amount of this chemical available to the brain. They do not, however, keep the nerve cells from dying (the underlying cause of the disease)

Treatment with a cholinesterase inhibitor such as donepezil (Aricept), rivastigmine (Exelon), or galantamine (Reminyl) can be started as soon as Alzheimer's Disease has been diagnosed. Another type, tacrine, is rarely used any more because it carries a risk of liver damage. The effect of these medications usually is not dramatic, and they may not work for everyone who has the disease.

Donepezil usually is tried first because it requires only one dose per day (all of the others require 2- 4 doses per day and a gradual dose escalation over time). It may take several weeks before the medication has any effect. If no improvement has occurred after 6 to 8 weeks, the dosage may be increased. If the increased dosage does not result in improvement, the medication may be stopped. Treatment may be stopped at any time if the person is unable to tolerate side effects from the medication.

If the person shows improvement, and the benefits of treatment outweigh any side effects, treatment with the medication usually is continued until the person stops responding to it. The person's response to the medication needs to be assessed on a regular basis, although this can be difficult. The medication may remain effective longer in some people than in others.

Side effects are most often upset stomach and diarrhea, although in unusual circumstances some agitation may also occur.

Memantine

A different type of medication to treat the symptoms of dementia, Memantine was recently approved by the FDA. This medication has been used to treat Alzheimer's symptoms in Europe for several years. It does not seem to be as effective as anticholinergic medications but may be an option in later stages of the disease. It does not appear to alter progression of the disease either. For more information on Memantine, from the Alzheimers Association, click here.

Antidepressants

Depression occurs in about 40% of people who have Alzheimer's Disease. Antidepressants can relieve symptoms of depression and may improve quality of life.