How is Alzheimer’s treated?

At this time, there is no cure nor disease-slowing treatments available for Alzheimer’s disease (AD). Current available treatments focus on maximizing cognitive abilities.

Four U.S. Food and Drug Administration (FDA) approved medications are used to treat Alzheimer’s disease:  Donepezil (Aricept*), rivastigmine, (Exelon*), galantamine (Razadyne*), and Memantine (Namenda*).  Aricept, Exelon, and Razadyne are acetylcholinesterase inhibitors, which stop the breakdown of acetylcholine, a neurotransmitter or chemical messenger that facilitates communication between cells.  Namenda, an NMDA receptor antagonist, regulates the level of another neurotransmitter, glutamate.  Excess glutamate in Alzheimer’s disease is hypothesized to contribute to overstimulation (i.e., “excitotoxicity”) and cell death.

Aricept and Exelon are approved for use at all stages of Alzheimer’s disease, while Razadyne is specifically for individuals with mild-to-moderate impairment.  Namenda is only medication for moderate-to-severe Alzheimer’s disease.  All four medications can enhance cognitive abilities and improve everyday functioning.  These drugs do not change the underlying disease process, which continues inexorably.

To learn more about currently approved medications for Alzheimer’s disease, view the UCI MIND Family Education Series session, Advances in Dementia Treatment: Current and Future Medications.

Managing behavioral symptoms

In Mild Cognitive Impairment (MCI) and throughout the course of Alzheimer’s disease, affected individuals can experience a variety of behavioral and psychological symptoms.  Common symptoms include apathy, depression, agitation, anxiety, paranoia, hallucinations, and wandering.  Symptoms vary from individual to individual and wax and wane during the disease process.  Guiding principles in the treatment of behavioral and psychological symptoms of dementia are:

  • Rule out unrecognized medical illnesses that could be causing a change in behavior.
  • If there is no medical cause, try non-pharmacological strategies first to manage the symptom.
  • Use medications with caution, as the antipsychotic drugs frequently prescribed for behavioral and psychological symptoms of dementia are not approved for this use, have little benefit, and come with significant side effects, including increased risk for death.
  • Partner with your doctor to address behavioral symptoms and the use of medication, when necessary.
  • Attend to caregiver stress.

To learn more,

Slowing, delaying, or preventing Alzheimer’s disease

Scientists today are looking beyond treating the symptoms of Alzheimer’s disease to addressing the underlying disease process.  Clinical trials are testing many possible interventions, such as immunotherapy and other anti-amyloid treatments, neuroprotective interventions, cognitive training and physical activity, and other treatment strategies.