Medication for dementia

Dementia is a progressive condition, and currently, there is no known cure. However, for some types of dementia, medication may help to relieve some of the symptoms or slow its progression. Our dementia specialist Admiral Nurses explain some of the medication options and how to support a person with dementia to take their medicines.  

What medication is used for dementia?

Medication for dementia is mostly prescribed for Alzheimer’s disease. However, people with other forms of dementia may also benefit from taking medication. 

Medication for Alzheimer’s disease

The main types of medication for Alzheimer’s disease are called ‘cholinesterase inhibitors’. They do not cure dementia or stop it worsening, but may slow down the progression and ease some of the symptoms.  

There are three types of cholinesterase inhibitor that may be used for Alzheimer’s disease: 

• donepezil 
• rivastigmine  
• galantamine 

Cholinesterase inhibitors are usually prescribed for people with early to middle stage dementia, and tend to be most effective in the first six to 12 months of taking the medication.  

Some people may be prescribed another medication for Alzheimer’s disease, called memantine. It is most often used for people who cannot take cholinesterase inhibitors, usually due to side effects or other medical conditions. It may be taken alongside a cholinesterase inhibitor in the middle to later stages of dementia. 

Medication for vascular dementia

Medications for Alzheimer’s disease do not help with vascular dementia. However, people living with vascular dementia – which is caused by problems with blood supply to the brain, for example as the result of a stroke or transient ischaemic attack (TIA, or ‘mini stroke’) – may be prescribed medicines to help with the underlying causes. These include medication for high blood pressure, high cholesterol and heart disease. 

Medication for Lewy body dementia

Some people with Lewy body dementia may be prescribed a cholinesterase inhibitor or memantine. They may also be prescribed antipsychotic medication to help with hallucinations, but this should only be used in severe cases as they can cause significant side effects. 

Medication for frontotemporal dementia

People with frontotemporal dementia are generally not prescribed Alzheimer’s medication as it could make the symptoms worse. However, some people with frontotemporal dementia might be prescribed a specific type of antidepressant called a ‘selective serotonin reuptake inhibitor’ (SSRI) to help with uninhibited or compulsive behaviour and overeating. 

Medication for mixed dementia

There is no specific medication for mixed dementia – where two or more forms of the condition occur together – but if the person’s dementia is thought to include Alzheimer’s disease, they may be prescribed a cholinesterase inhibitor. 

Medication for Huntington’s disease

Dementia is common in people with Huntington’s disease. There is no specific medication to treat this condition, but people with the diagnosis may be prescribed medicines to help with specific symptoms such as depression and twitching/jerking movements. 

Medication for Parkinson’s dementia

Parkinson’s predominantly affects movement, but around one third of people with the diagnosis go on to develop dementia. While it cannot be cured, many people will take a drug called dopamine to help manage the symptoms. People with Parkinson’s dementia may also be prescribed a cholinesterase inhibitor. 

Medication for posterior cortical atrophy (PCA)

PCA is a rare type of dementia that most commonly develops between the ages of 50 and 65. Cholinesterase inhibitors may be helpful for people with PCA. 

Medication for young onset dementia

Young onset dementia refers to any form of dementia that develops before the age of 65. There is no specific medication for young onset dementia, but a person with the condition may be prescribed the medication suited to their particular form of dementia. 

How medication for dementia works

Dementia medications work in different ways. For example: 

• Cholinesterase inhibitors block the breakdown of a brain chemical called acetylcholine, which is needed for memory and learning 
• Memantine limits excess levels of calcium in the brain, which may reduce the rate of damage to the brain cells 

What to consider before taking dementia medication

Before starting medication for dementia, it is important to weigh up the pros and cons in conjunction with the doctor. They will carefully consider:  

• whether the medication is suitable for the person’s type of dementia  
• the likelihood of side effects and whether they will be outweighed by the benefits  
• any other health conditions  
• potential interactions with other medicines the person is already taking 
• the person’s ability to take the medication as prescribed 

What are the possible side effects of dementia medication?

All medications have some risk of side effects. These are listed in the patient information leaflet which comes in the packaging.  

Common side effects of cholinesterase inhibitors include:  

• diarrhoea, nausea and/or vomiting  
• headaches  
• dizziness  
• loss of appetite  
• muscle cramps  
• fatigue  
• insomnia  

Common side effects of memantine include:  

• constipation  
• drowsiness  
• headache  
• hypertension (high blood pressure)  
• dizziness  

Some side effects may only occur when first starting the drug or when increasing the dose. To minimise the risk, the prescriber will often start with a low dose of medication and gradually increase it.  

If you need advice around side effects, you can speak to the person’s doctor or a community pharmacist. 

How dementia medication can interact with other medicines

When someone takes more than one medication they may interact with each other, causing side effects or reducing their effectiveness. Drugs for dementia may interact with other medications, for example antipsychotics or tricyclic antidepressants, so the doctor will always consider what medicines the person already takes before deciding whether to prescribe dementia medication. 

Managing medication for dementia

A person with dementia may need support with managing their medication – for example remembering to take it, taking the correct dose at the right time and storing it safely.