Drug treatments

Key points

Physicians may prescribe various types of medication for the person, including:

• Symptomatic drugs
• Drugs for non-Alzheimer's disease dementia
• Drugs for improving behavioural and psychological symptoms

Caregivers can also help people with dementia to have a regular exercise routine, maintain a healthy diet, enjoy everyday life, engage in social activities, manage their medications, and utilize their cognitive abilities. All of these can slow down the progression of the disease.

Symptomatic drugs

• Acetylcholinesterase inhibitors or cholinesterase inhibitors
  • Such as donepezil (Aricept®), rivastigmine (Exelon®), and galantamine (Reminyl®).
  • Effect: Improve cognitive functions.
• N-methyl-D-aspartate (NMDA) receptor antagonists
  • Such as memantine (Namenda®, Ebixa®).
  • Effect: Improve cognitive functions.

For reference only. Please consult your physician if you have any queries. Interactions of medications can be fatal. Do not let the person purchase or take any medication that is not prescribed by a physician.

Drugs for non-Alzheimer's disease dementia

• Medications for controlling blood pressure, diabetes and heart disease
  • Effect: Prevent strokes for persons at risk of or having vascular dementia.
• Antiplatelet drugs and anticoagulants such as aspirin and warfarin
  • Effect: Prevent another stroke for persons with vascular dementia.
• Supplements such as vitamin B supplements
  • Effect: To replace of vitamin B for those with vitamin B deficiency-related dementia.

For reference only. Please consult your physician if you have any queries. Interactions of medications can be fatal. Do not let the person purchase or take any medication that is not prescribed by a physician.

Drugs for improving behavioural and psychological symptoms

1. Mood stabilizers (or anticonvulsants)

   • Such as valproate (Epilim®), gabapentin (Neurontin®), and carbamazepine (Tegretol®).
   • Effects: Stabilize the mood, reduce impulsivity, reduce aggression, etc.
   • Side effects: Dizziness, impaired reactions, ataxia, etc.

2. Antipsychotics

   • Such as chlorpromazine, haloperidol (Haldol®), risperidone (Risperdal®), and quetiapine fumarate (Seroquel®).
   • Effects: Reduce agitation, irritation, impulsivity, hallucination, delusion, etc.
   • Side effects: Consitipation, dry mouth, drowsiness, weight gain, etc.

3. Antidepressants

   • Such as amitriptyline (Tryptanol®), fluoxetine (Prozac®), paroxetine (Seroxat®), sertraline (Zoloft®), venlafaxine (Effexor®), and escitalopram (Lexapro®).
   • Effects: Improve depressive mood, reduce obsessive-compulsive symptoms, etc.
   • Side effects: Fast or uneven heartbeats, nausea or upset stomach, etc.

4. Anxiolytics

   • Such as benzodiazepines (Xanax®, Valium®, Ativan®) and propranolol (Inderal®).
   • Effects: Reduce anxiousness.
   • Side effects: Tiredness, decrease blood pressure, etc.

5. Hypnotics (sleeping pills)

   • Such as benzodiazepine (Ativan®), non-benzodiazepine (Imovane®), and zolpidem (Stilnox®).
     Effects: Reduce insomnia, reduces nighttime behaviour.
   • Side effects: Drowsiness, feeling light-headed, impaired thinking or reactions.
   • Benzodiazepine may induce confusion and increase the risk of falls. It is usually prescribed for only a short time.

For reference only. Please consult your physician if you have any queries. Interactions of medications can be fatal. Do not let the person purchase or take any medication that is not prescribed by a physician.

Safety precautions

1. Pay attention to side effects

   • Inform your physician immediately or take the person to the nearest emergency department if the person has serious side effects such as allergic response, loss of consciousness, irregular heartbeat, confusion (delirium), excessive sleepiness, slow or minimal response, vomiting, difficulty swallowing, and involuntary movements.
   • These medications have different kinds of side effects. Inform your physician about any unusual or bothersome side effects in the next appointment.
   • Most medications can be replaced by others. Ask your physician about the possibility of switching to other brands or other medications if you notice any unusual or bothersome side effects.

2. Taking and storing medications

   • Ensure the person is taking medications exactly as they were prescribed by the physician and go to follow-up appointments as directed.
   • Make sure the person has swallowed the medications as he or she may hide them under the tongue.
   • Do not store the medications in the refrigerator unless told to do so by the physician.
   • Do not put or store the medications under the sun.
   • Keep the medications out of the reach of the person and keep track of them to prevent overdose.

3. Changing dosages, brands and medications, and stopping medications

   • Do not change the dosage or stop using the prescribed medications unless there are serious side effects.
   • It may take weeks or months for some medications to show any effects. Do not change the dosage or stop using the prescribed medications during this period.
   • Inform the physician and seek advice immediately if the person really has to change the dosage or stop taking the prescribed medications.
   • Ask the physician to check all the medications the person is taking whenever there is a change in medications to prevent interactions.
   • Observe the person for any changes after changing medications. The recommended length of the observation period is at least a week. Inform the physician immediately and seek advice if there are any changes or if there is a worsening of symptoms or side effects.