ask your pharmacist

back to: pharmacy | ask your pharmacist

Are there any prescription treatments for Alzheimer’s disease?

Alzheimer’s disease is a brain disorder that can affect a person’s thoughts and behavior. This disease causes a loss of mental abilities over time, along with dementia, depression, aggression, and other symptoms. The cause or causes of Alzheimer's disease are unknown, and no cure is available. Treatments can only relieve symptoms.

Some prescription medicines can slow the advancing symptoms of Alzheimer's disease. The four FDA-approved drugs are donepezil (brand name Aricept), rivastigmine (>Exelon), galantamine (Reminyl) and tacrine (>Cognex). These work by raising the amount of the chemical acetylcholine in the brain. They can temporarily relieve certain symptoms and postpone the later stage of disease by six months to two years. Aricept reportedly relieves depression and slows memory loss for up to a year. Exelon improves memory, reasoning, and language for up to six months. Cognex reduces depression for up to six months in some people. However, liver problems are common with Cognex, so anyone with liver disease should avoid this drug.

In October 2003, the FDA approved the drug memantine (Namenda), which is indicated to treat moderate to severe Alzheimer’s stages. It seems to slow the loss of normal daily living skills.

As Alzheimer’s disease progresses, the only way to help those affected is to treat the symptoms. Depression is a common symptom of this disease, In many cases antidepressants such as >fluoxetine (>Prozac), paroxetine (>Paxil), and sertraline (>Zoloft) can provide relief.

Friends and family can also use nondrug strategies to help reduce the person's depression and aggression. Try to limit the number of choices a person has to make, reduce distractions, and maintain a consistent routine. Reduce clutter, but keep things located in the same place. Keep noise levels down. Learn to recognize--and avoid--activities that prompt outbursts or unwanted behavior. To deal with declining memory, use notebooks, colored labels, or lists to help the person to remember things.

Sources:
“Alzheimer's” Pharmacist’s Letter 17 (5). Pharmacists Letter Inc. 2001.
Diseases and Conditions, "Alzheimer’s Disease." http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 12/6/2006.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
Goetz C. G. Textbook of Clinical Neurology, 1st ed. W. B. Saunders Company, 1999.
Grutzendler, J. “Cholinesterase Inhibitors for Alzheimer's Disease.” Drugs 61(2001).
Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Rogers S.L., M.R. Farlow, R.S. Doody, R. Mohs, L.T. Friedhoff. “A 24-Week, Double-Blind, Placebo-Controlled Trial of Donepezil in Patients with Alzheimer’s Disease.” Neurology. 50 (1998).
Rosler M., R. Anand, A. Cicin-Sain, S. Gauthier, Y. Agid. “Efficacy and Safety of Rivastigmine in Patients with Alzheimer’s Disease: International Randomized Controlled Trial.” British Medical Journal. 318 (1999).
Tasman A. Psychiatry, 1st ed. W. B. Saunders Company, 1997.
The American Psychiatric Press Textbook of Psychopharmacology. American Psychiatric Press Inc., 1998.
Wilcock, G. “Efficacy and Safety of Galantamine in Patients with Mild to Moderate Alzheimer's Disease: Multicentre Randomised Controlled Trial.” British Medical Journal. 321 (2000).