Medications for the Treatment of Alzheimer's and Dementia

Alzheimer’s and dementia affect an estimated 6.9 million people in the U.S. and may touch the lives of one in two people alive in Western countries today. Fortunately, Alzheimer's care is improving significantly, and new medications are coming to the market. 

These fall into two categories: pills that fight the progression of the disease, and those that treat symptoms. In this post, we explore both, describing various pros and cons of Alzheimer's medication and how anti-dementia drugs work. 

Alzheimer's Medications

The FDA approves several medications for treating dementia and Alzheimer’s patients. These include drugs for those with mild cognitive impairment and the most severe forms of the disease. 

Aducanumab

Aducanumab marketed as “Aduhelm” is a monthly intravenous infusion therapy designed to slow the progression of dementia. The FDA recently approved it for treating both Alzheimer’s and mild cognitive impairment. 

The treatment works by removing beta-amyloid from the brain – the plaques some researchers believe are responsible for the disease’s development. 

This Alzheimer's medication side effects include headaches, increased risk of falls, brain bleeding, and brain swelling. 

Lecanemab

Lecanemab marketed as Leqembi works similarly, delivered via injection every two weeks. Doctors are more likely to use the drug in the early stages of dementia because most studies of the medication cover this period. 

Lecanemab has shown some promise in clinical trials and is FDA-approved. However, it can also cause side effects in 25% of patients, including chills, flushing, rashes, and body aches.

Donanemab

Donanemab, marketed as Kisunla, works in the same way as aducanumab, again attempting to break down the troublesome beta-amyloid plaques in the brain. Unfortunately, the drug can cause severe allergic reactions in some patients. 

Cholinesterase Inhibitors

Cholinesterase inhibitors are a more established class of drugs that work differently from those discussed. Instead of trying to fix the cause of dementia, they attempt to improve the symptoms of the disease. 

The drugs work by inhibiting the action of cholinesterase, the enzyme that breaks down the neurotransmitter choline in the brain. The thinking is that this approach allows communication signals to persist for longer, allowing remaining functional brain cells to talk to each other more efficiently. 

Cholinesterase inhibitors come under various brand names. Aricept targets all stages of dementia while Exelon and Razadyne are for mild-to-moderate patients. 

Glutamate Regulators

Glutamate regulators adopt a similar approach. These medications manage the production of the chemical messenger glutamate, improving memory, reasoning, language, and attention. 

This drug is mainly for managing the symptoms of patients with moderate-to-severe Alzheimer’s disease. It is effective in some patients, but can also cause side effects including dizziness, constipation, and headache. 

Orexin Receptor Antagonists

Finally, some doctors prescribe dementia patients orexin receptor antagonists. These drugs inhibit the activity of orexin to regulate the sleep-wake cycle better. 

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