Caring for a Person with Alzheimer's Disease

Medicines to Treat AD Symptoms and Behaviors

This chapter contains medical terms and drug names.

"Dad was nervous and depressed at the same time. He couldn’t sit still, but he also didn’t sleep well. His doctor gave him medicine to help. At first, he was too sleepy. Then, the doctor adjusted the medicine, and Dad’s doing better."

People with AD may take medications to treat:

  • The disease itself
  • Mood or other behavior changes
  • Other medical conditions they may have

Caregivers need to know about each medicine that a person with AD takes.

Ask the doctor or pharmacist the questions below and write down the answers:

  • Why is this medicine being used?
  • What positive effects should I look for, and when?
  • How long will the person need to take it?
  • How much should he or she take each day?
  • When does the person need to take the medicine?
  • What are the side effects?
  • What can I do about these side effects?
  • Can the medicine be crushed and mixed into foods such as applesauce?
  • Can I get the medicine in a liquid form?
  • Can this medicine cause problems if taken with other medicines?

Reminders to take medicine

a person opening a pillboxPeople with AD often need help taking their medicine. If the person still lives alone, you may need to call and remind him or her. It’s also helpful to buy a pillbox and put pills for each day in the box. That way all the pills for the day are in one place. You can get pillboxes at the drugstore. As the disease gets worse, you will need to keep track of his or her medicines. You also will need to make sure they take the medicine or you will need to give them the medicine. Ask the doctor or pharmacist about when to give the medications.

 

Medicines to treat AD

Both caregivers and doctors need to remember that no two people with AD are alike. This means that medications may work differently in different people.

Many factors may play a role in the disease, such as:

  • Genes
  • Lifestyle
  • Earlier treatments
  • Other illnesses or problems
  • The person’s surroundings
  • Stage of AD

Work closely with the doctor to learn which medicines to use for AD, how much to use, and when to use them. Check with the doctor to see if Medicare or private insurance will cover the cost of the medicines. Also, find out if you can buy the non-brand, also called generic, type of the medicine. They often cost less than the brand name medicines.

When this guide was written, four medicines (see below) were approved to treat AD. Other promising new medicines are being tested.

doctor and 3 older people sitting at a round tableIt's important to understand that none of the four medicines can cure or stop the disease. What they can do, for some people, is help them improve for a while from where they started. However, most of the time, these medicines work to slow down certain problems, such as memory loss. Slowing down memory loss can allow many people with AD to be more comfortable and independent for a longer time.

 

Medicines for mild to moderate AD

Three of the four medicines to treat AD are similar. They are used to treat mild to moderate stages of the disease. They may help delay or slow down some symptoms. One of the medicines, Aricept®, also may help people with severe AD.

The names of these three medicines are:

  • Aricept® (AIR-uh-sept), brand name; donepezil (doe-NEP-uh-zil), generic name
  • Exelon® (EKS-uh-lawn), brand name; rivastigmine (riv-uh-STIG-meen), generic name
  • Razadyne® (RAZZ-uh-dine), brand name; galantamine (guh-LAN-tuh-meen), generic name

A medicine for moderate to severe AD

Namenda®, the fourth medicine, is used to treat moderate to severe AD. For some patients, Namenda® (nuh-MEN-duh) may delay or slow the symptoms of AD. This may allow some people to do more things for themselves, such as using the toilet. The generic name of this drug is memantine (MEH-man-teen).

Sometimes doctors use a combination of medicines to treat moderate to severe AD. For example, they might use Aricept® and Namenda®. These two medicines work in different ways, so it is safe to take them together.

Ask the doctor about side effects

Check with the doctor or pharmacist about any possible side effects of medications. Some side effects can be serious.

Medicines to treat behavior problems related to AD

hands holding pill bottle with other bottles in backgroundExamples of behavior problems that can occur in AD are restlessness, anxiety, depression, trouble sleeping, and aggression. Experts agree that medicines to treat these behavior problems should be used only after other strategies that don't use medicine have been tried. Some of these tips are listed in "Challenge: changes in personality and behavior". If they don't work and the person with AD continues to be upset, restless, depressed, or aggressive, he or she may need medicine. Talk with the doctor about which medicines are safest and most effective to help with these problems.
 

Remember the following tips about medicines:

  • Use the lowest dose possible.
  • Watch for side effects. Be prepared to stop the medicine if they occur.
  • Allow the medicine a few weeks to take effect.

Know about medicines

Information about medicines changes over time. Check with the doctor, AD specialist, or pharmacist about the latest medicines. The doctor may prescribe newer drugs with different names than those listed in this guide. Also, remember that some medicines have both generic and brand names.

Below is a list of medicines used to help with depression, aggression, restlessness, and anxiety.

Antidepressants are drugs used to treat depression and worry (also called anxiety).

Examples of these medicines include:

  • Celexa® (Sa-LEKS-a), brand name; citalopram (SYE-tal-oh-pram), generic name
  • Remeron® (REM-er-on), brand name; mirtazepine (MUR-taz-a-peen), generic name
  • Zoloft® (ZO-loft), brand name; sertraline (SUR-truh-leen), generic name

Anticonvulsants are drugs sometimes used to treat severe aggression.

Examples of these medicines include:

  • Depakote® (DEP-uh-cote), brand name; sodium valproate (so-DEE-um VAL-pro-ate), generic name
  • Tegretol® (TEG-ruh-tall), brand name; carbamazepine (KAR-ba-maz-ee-peen), generic name
  • Trileptal® (tri-LEP-tall), brand name; oxcarbazepine (oks-kar-BAZ-eh-peen), generic name

Medicines to be used with caution

There are some medicines, such as sleep aids, anti-anxiety drugs, and antipsychotics, that the person with AD should take only:

  • After the doctor has explained all the risks and side effects of the medicine
  • After other, safer medicines have not helped treat the problem

You will need to watch closely for side effects from these medications.

Sleep aids are used to help people get to sleep and stay asleep. People with AD should NOT use these drugs on a regular basis because they make the person more confused and more likely to fall.

Examples of these medicines include:

  • Ambien® (AM-bee-un), brand name; zolpidem (zole-PI-dem), generic name
  • Lunesta® (lu-NES-ta), brand name; eszopiclone (ess-ZOP-eh-klone), generic name
  • Sonata® (SO-nah-ta), brand name; zaleplon (ZAL-ee-plon), generic name

Anti-anxiety drugs are used to treat agitation. These drugs can cause sleepiness, dizziness, falls, and confusion. Therefore, doctors recommend using them only for short periods of time.

Examples of these medicines include:

  • Ativan® (AT-eh-van), brand name; lorazepam (lor-AZ-eh-pam), generic name
  • Klonopin® (KLON-uh-pin), brand name; clonazepam (kol-NAY-zeh-pam), generic name

Antipsychotics are drugs used to treat paranoia, hallucinations, agitation, and aggression. See "Challenge: changes in personality and behavior" for more about these conditions. Side effects of using these drugs can be serious, including increased risk of death in some older people with dementia. They should ONLY be given to people with AD when the doctor agrees that the symptoms are severe.

Examples of these medicines include:

  • Risperdal® (RISS-per-doll), brand name; risperidone (riss-PAIR-eh-dohn), generic name
  • Seroquel® (SAIR-o-kwell), brand name; quetiapine (KWE-tye-uh-peen), generic name
  • Zyprexa® (zye-PREKS-uh), brand name; olanzapine (o-LAN-zuh-peen), generic name

Medicines that people with AD should not take

Anticholinergic drugs are used to treat many medical problems such as sleeping problems, stomach cramps, incontinence, asthma, motion sickness, and muscle spasms. Side effects, such as confusion, can be serious for a person with AD. These drugs should NOT be given to a person with AD. You might talk with the person's doctor about other, safer drugs.

Examples of these drugs include:

  • Atrovent® (AT-row-vent), brand name; ipratropium (EYE-pra-troe-pee-um), generic name
  • Combivent® (COM-bi-vent), brand name; ipratropium and albuterol (EYE-pra-troe-pee-um and AL-bu-ter-all), generic names
  • DuoNeb® (DO-oh-neb), brand name; ipratropium and albuterol (EYE-pra-troe-pee-um and AL-bu-ter-all), generic names
  • Spiriva® (SPY-ree-vah), brand name; tiotropium (TEE-oh-tro-pee-um), generic name

Medicines to treat other medical conditions

older African American couple paying billsMany people with AD also have other medical problems such as diabetes, high blood pressure, or heart disease. They may take different medicines for these problems. It’s important to track all the medicines they take. Make a list of their medicines and take the list with you when you visit their doctors.

Publication Date: July 2012
Page Last Updated: August 26, 2014