by EBSCO Medical Review Board

Here are the basics about each of the medicines below. Only the common reactions are listed.

Medicine cannot cure Alzheimer disease. Medicine is used to help manage symptoms.

Prescription Medications

Cholinesterase Inhibitors

Common cholinesterase inhibitors are:

  • Donepezil
  • Rivastigmine
  • Galantamine

These medicines help improve memory and cognitive function. They slow the breakdown of a chemical that helps cells communicate with one another. This may slow the disease in some people.

Some problems may be:

  • Nausea, vomiting
  • Diarrhea
  • Belly pain or cramping
  • Slowing of heart rate
  • Headache
  • Lack of hunger
  • Bowel movements that happen more often
  • Liver problems
  • Rashes
  • Light-headedness and fainting
  • Facial flushing

Glutamate is a chemical that is thought to be toxic to nerve cells. Memantine blocks the effects of this chemical. It may improve daily function and thinking. People with severe kidney problems should not take it.

Some problems may be:

  • Headache
  • Confusion
  • Nausea and vomiting
  • Constipation
  • Drowsiness
  • Seeing things that are not really there
  • Cough
  • Diarrhea
Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant used to treat low mood, depression, anxiety, and irritability.

Some SSRIs that are used are:

  • Citalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline

Some problems may be:

  • Drowsiness
  • Dry mouth
  • Blurred vision
  • Nausea
  • Light-headedness
  • Weight gain
  • Problems sleeping
  • Sexual dysfunction
  • Risk of severe mood and behavior changes, including suicidal thoughts in some people
Anti-anxiety Medications

Anti-anxiety medicines are in a class called benzodiazepines. They can ease anxiety as well as physical symptoms like muscle spasms. They are known to cause drowsiness. They can be habit-forming when used for too long or when too much is taken. This can worsen problems with memory. These drugs should also not be stopped too quickly. Serious side effects, such as seizures, may happen.

Some medicines that are used are:

  • Lorazepam
  • Oxazepam

Some problems may be:

  • Drowsiness
  • Light-headedness
  • Confusion
  • Weakness
  • Problems walking
  • Breathing problems
Antipsychotics

Antipsychotic medicines are used to ease agitation, hallucinations, delusions, and bizarre and violent behavior. They may not be helpful in all people with the disease.

Some medicines that are used are:

  • Olanzapine
  • Risperidone
  • Quetiapine

Problems that may happen from taking olanzapine are:

  • Agitation
  • Behavior problems
  • Problems speaking or swallowing
  • Restlessness
  • Stiff arms or legs
  • Trembling or shaking of hands and fingers

Tardive dyskinesia may happen from taking risperidone and quetiapine. This health problem causes people to move their face and jaw without control.

Some side effects may not be able to be reversed.

Special Considerations

When taking medicine:

  • Take your medicine as advised. Do not change the amount or schedule.
  • Be aware of the side effects of your medicine. Tell your doctor if you have any.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Do not share your prescription medicine.
  • Medicines can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one, including over the counter products and supplements.
  • Plan for refills.

References

Alzheimer dementia. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/alzheimer-dementia . Updated August 9, 2019. Accessed October 8, 2019.

Alzheimer's disease medications fact sheet. National Institute on Aging website. Available at: https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-sheet. Updated April 2, 2018. Accessed October 8, 2019.

Atri A. The Alzheimer's Disease Clinical Spectrum: Diagnosis and Management. Med Clin North Am. 2019 Mar;103(2):263-293.

Treatments. Alzheimer’s Association website. Available at: https://www.alz.org/alzheimers-dementia/treatments. Accessed October 9, 2019.

What is Alzheimer's? Alzheimer’s Association website. Available at: http://www.alz.org/alzheimers%5Fdisease%5Fwhat%5Fis%5Falzheimers.asp. Accessed October 8, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2019
  • Update Date: 10/27/2020