Any treatment of dementia depends on its cause. There are drug treatments available that can in some cases slow the progress of the disease and alleviate symptoms, but as yet there is no cure. After thorough diagnosis and careful consideration your doctor will determine if you might benefit from a drug treatment.
In the UK the most common drugs prescribed to people with dementia are:
This type of medication helps prevent certain enzymes from breaking down a substance called acetylcholine in the brain, acetylcholine helps nerve cells communicate with each other and it’s these nerve cells are commonly impaired in people with Alzheimer’s and dementia. Donepezil (also known as Aricept), Rivastigmine (Exelon) and Galantamine (Reminyl) can be used to treat the symptoms of mild to moderate Alzheimer’s disease. Donepezil is also used to treat more severe Alzheimer’s disease. There is some evidence that these medicines can help treat people with mixed dementia conditions such as combinations of Lewy bodies dementia and Parkinson’s disease dementia, as well as people who have a mixed dementia diagnosis of Alzheimer’s disease with vascular dementia. There is little difference between the effectiveness of each of these medicines but some may target specific symptoms, for example rivastigmine may be preferred if hallucinations are present.
This medication (also known as Namenda) is mostly prescribed for people who for a variety of reasons can’t take acetylcholinesterase inhibitors. It works by blocking the effects of an excessive amount of a chemical in the brain called glutamate. It is
appropriate for people with moderate or severe Alzheimer’s disease, dementia with Lewy bodies and those with a combination of Alzheimer’s disease and vascular dementia.
Anti-depressants and Anti-psychotics
Some people with dementia may develop distressing and potentially harmful symptoms such as agitation, anxiety, aggression, delusions and hallucinations. There are drugs that can be prescribed to alleviate some of these symptoms. Known as anti-psychotic medications, risperidone or haloperidol may be appropriate for those that have exhibited aggression or extreme distress. Both risperidone and haloperidol are effective for people with moderate to severe Alzheimer’s and haloperidol can be prescribed specifically for people with vascular dementia. Both of these medications can have serious side effects and as such will only be prescribed by a psychiatrist.
Anti-depressant medication may be given to some people with dementia if depression is determined to be the cause of anxiety or agitation. At present evidence is mixed as to how effective these drugs are but some doctors feel they are still worth trying in some specific cases. The anti-depressant drugs most widely prescribed for those with dementia are sertraline, citalopram, mirtazapine and trazodone.
Non drug treatments can be equally as valuable as taking medication particularly in the early stages of a dementia journey.
Some of the treatments that might be helpful include:
Cognitive Behavioural Therapy
This is a type of psychotherapy to counter depression and anxiety.
Cognitive Stimulation Therapy
To keep the mind active with themed activity sessions that challenge the brain. this can help people with memory, problem solving skills and retaining language skills.
Cognitive Rehabilitation Therapy
This might involve working with someone such as an occupational therapist to try and regain a lost skill or to develop new compensating skills.
Telling or documenting personal experiences and memories, to improve mood, well-being, and mental function.
Singing, Dancing, Art
Activities that keep you physically, mentally, and socially engaged can boost confidence and cognitive skills and lower anxiety.
This might be sessions with a mental health counsellor or meetings with a support group. This can help an individual to cope with the emotional challenges of a dementia diagnosis.