Medication for Dementia

Those who have mild to moderate symptoms of Alzheimer’s disease, Lewy body dementia, or vascular dementia may be given a cholinesterase inhibitor, a type of medication that boosts levels of acetylcholine, a brain chemical that plays a role in memory and learning. For about half of the people who take them, cholinesterase inhibitors, such as donepezil, or Aricept^®, among others, can slow the worsening of memory loss and confusion for 6 to 12 months, on average. Side effects include nausea, vomiting, and loss of appetite. 

As dementia progresses, additional medications such as memantine, or Namenda^®, may be prescribed. Memantine blocks glutamate, a brain chemical that in excessive amounts may worsen memory function. Side effects include dizziness, diarrhea, and headache. 

Depression may accompany any of the types of dementia, causing a person to become increasingly withdrawn. Also, coping with a chronic illness can intensify or lead to depression, which can worsen behavioral symptoms such as irritability or aggression. 

NYU Langone doctors may recommend a type of antidepressant medication called a selective serotonin reuptake inhibitor (SSRI). SSRIs block the “reuptake,” or reabsorption, of serotonin, a chemical messenger that allows signals to be sent and received among brain cells, or neurons. Having more serotonin available for brain and body processes helps in regulating mood, appetite, and sleep. Side effects of SSRIs may include insomnia, anxiety, nausea, and diarrhea.

These medications may be prescribed for people with some types of dementia, particularly vascular dementia and frontotemporal dementia. Antipsychotic medications may reduce symptoms such as hallucinations, paranoia, agitation, and aggression but can produce serious side effects in older people with dementia, including increasing the risk of dying from a cardiovascular cause such as stroke. 

Doctors at NYU Langone use these medications with caution, carefully monitoring their use. 

Medications that control blood pressure, cholesterol levels, diabetes, or heart disease may help prevent further damage to the blood vessels in the brain. High blood pressure, high cholesterol, and diabetes are risk factors for stroke and heart disease, which can lead to vascular dementia. Side effects of medications that control these conditions include dizziness, headaches, or nightmares.

NYU Langone doctors recommend regular appointments for people with dementia to ensure that their medication is working and to manage any side effects.