Treatments for Alzheimer’s Disease
Medication for Alzheimer’s disease may help slow changes in memory, thinking, and reasoning. For some people, these medicines can help them stay independent longer and continue doing everyday activities. This can support a better quality of life for both the person with Alzheimer’s and their family.
Medications do not work for everyone, and they may become less helpful as the disease progresses. They tend to work best for people in the earlier stages of disease.
Researchers are working hard to develop new and better medicines. If the current ones are not right for you, ask your healthcare professional whether a clinical trial might be an option.
FDA-Approved Therapies for Alzheimer’s Disease
There are currently two types of medication therapies for people with Alzheimer’s disease. One type, known as symptomatic therapy, treats the symptoms of the disease to improve quality of life. These medications do not change the disease course, and their benefits may disappear over time or if the medication is stopped. The other type of treatment, known as disease-modifying therapies (DMTs) target the underlying cause of the disease to slow or halt its progression. DMTs aim for a longer-lasting benefit that can slow, halt, or potentially reverse the disease process, even after treatment ends
The U.S. Food and Drug Administration (FDA) has approved several therapies for Alzheimer’s disease, with many people trying take one or more at some point in their journey. People with Alzheimer’s disease and their families should talk with their healthcare team about the benefits, side effects, and other risks of using these medications.
Symptomatic Treatments
- Cholinesterase Inhibitors, such as Donepezil (Aricept), Galantamine, and Rivastigmine help increase a brain chemical called acetylcholine, which supports memory and thinking. People with certain heart rhythm problems should not take these medicines.
- Memantine (Namenda) works on a brain chemical called glutamate to help slow down problems with memory and thinking. It is usually prescribed in moderate to later stages of Alzheimer’s disease. A combination pill, Namzaric, includes both memantine and donepezil.
- Brexpiprazole (Rexulti) is a medication that reduces agitation, restlessness, irritability, or emotional distress in people with Alzheimer’s disease.
Disease-Modifying Therapies: Antiamyloid Treatments
A newer group of treatments helps remove a protein called amyloid from the brain. Amyloid buildup is one of the changes seen in Alzheimer’s disease.
The FDA has approved: Lecanemab (Leqembi) and Donanemab (Kisunla) for people with Mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s disease. These medications are administered by IV, requiring patients to visit an infusion clinic every two weeks (for Lequembi) or four weeks (for Kinsula). The medications can slow decline in memory and thinking, but the effect is modest. Because these medicines are new, we do not yet know their long-term benefits or risks.
Unfortunately, many people with Alzheimer’s cannot take these medicines because of medical risks. People who carry the gene APOE-e4, especially two copies, have a higher chance of amyloid-related imaging abnormalities (ARIA), which includes brain swelling or bleeding. A genetic blood test is often recommended before starting treatment, and careful imaging studies are performed following the start of treatment to identify problems quickly. Fortunately, ARIA typically resolves when treatment is stopped.
Working With Your Healthcare Team
The key to effective Alzheimer’s disease treatment is being aware of the warning signs and seeking an evaluation early in the process, when more treatment options are available and have the most potential to help.
If your doctor believes medication can help, it is important that you speak openly about:
- What you hope medicines will do
- Possible side effects
- Whether new treatments are safe for you
- Clinical trial options
- When it might be time to change or stop a medicine
Every person and every family is different. Your healthcare team can help you understand the options and choose the best, most effective plan for you.