Dementia is a medical term that refers to a group of symptoms that progressively affect memory, thinking and social skills sufficiently to interfere with daily activities. Whilst most types of dementia cannot be cured, there are some medicationsfor dementia that can slow down the advancement of cognitive impairment.

Medication for Dementia

The medicines prescribed for dementia cannot totally stop or reverse the damage to brain cells, but they can slow down the symptoms or stabilize them. There are two types of medicines approved to treat dementia, namely cholinesterase inhibitors and memantine.

The following 2 stages of dementia have been identified which influence the type of treatment:

Early to Moderate Stages

• Type of medication: cholinesterase inhibitors to treat symptoms of memory loss and other cognitive impairment.
• Brand names: Razadyne, Aricept, Exelon
• Effects of medicine: cholinesterase inhibitors prevent the breakdown of acetylcholine, which is a chemical messenger vital for learning and memory in the brain. Keeping acetylcholine levels high in turn keeps nerve communication high. 50% of patients taking this medicine report a delay in worsening symptoms for about 6-12 months.
• Common side effects: nausea, vomiting, increased bowel movements and loss of appetite.

Moderate to Severe Stages

• Type of medication: memantine
• Brand names: Namenda
• Effects of medicine: memantine is a type of medication for dementia which regulates glutamate (a chemical messenger) involved in memory and learning. It is prescribed to patients to improve cognitive abilities like memory, attention span, reasoning ability, etc. It is thought to delay worsening of symptoms related to dementia.
• Common side effects: constipation, dizziness, confusion, headache, etc.

Medications for Accompanying Symptoms of Dementia

Dementia is often accompanied by other symptoms, which are behavioural and psychological in nature. These can include aggression, agitation, insomnia, depression, etc. Medication is often prescribed to control these other symptoms, in addition to the medications for dementia listed above.

1. Antipsychotics: they are also known as tranquilizers and are commonly prescribed to control aggression, agitation and delusions. Side effects of this group of drugs mimic symptoms of Parkinson’s disease, like shakiness, a shuffling gait and body stiffness. A previously common commercial medicine in this category is Haloperidol (Serenace). Newer products, like Risperidone (Risperdal), have fewer Parkinsonian side effects but may be associated with a higher risk of stroke.
2. Antidepressants: depression is a common symptom of dementia and there is a host of commonly prescribed antidepressants available commercially.
3. Anti-anxiety medication: a group of drugs called benzodiazepines are used to treat anxiety and panic attacks in people with dementia. However, people being treated with benzodiazepines quickly develop a dependency and tolerance to them. This means that over time, the drugs become less effective and the dosage has to be increased to achieve the same effect as before. A well-known and commonly prescribed benzodiazepine is Valium.
4. Sleep aids: insomnia and night-time wandering can create many problems both for the patient with dementia and the caregivers. The side effect of sleeping aids is the daytime drowsiness. Sleep aids should be prescribed as a last resort.

Important note:

Keep a detailed record of all your medicines and not just medication for dementia, which should include any alternative medications and over-the-counter remedies to prevent potential drug interactions. Your doctor and pharmacist must be made aware of any new medication you start on to ensure they don’t reduce or increase therapeutic blood levels of your existing medications.

Alternative Medicine and Supplements

Alternative remedies and dietary supplements are not very well regulated. There are very limited studies done to verify the manufacturers’ claims. Always speak to your doctor before you start taking any supplement.

These alternative therapies can be used to combat dementia:

• Vitamin E: it has been known to slow down nerve damage. However, it should be noted that larger doses of Vitamin E are dangerous to people with heart diseases.
• Omega-3 fatty acids: they are found naturally in nuts and fish, and have been proven to reduce mild cognitive impairment in addition to reducing your risk of heart diseases and strokes.
• Coenzyme Q10: this is found naturally in the body and is an antioxidant. Synthetic supplements are available but further studies are required to find the optimum dosage for the best results.
• Ginkgo: there is some conflicting evidence as to whether this extract from the Ginkgo Biloba tree has any antioxidant and anti-inflammatory effects on the brain cells.
• Relaxation: in addition to the medication for dementia, calming dementia patients down can also reduce agitation and anxiety. Listening to soothing music, playing with pets, use of aromatherapy or massage can all induce relaxation to minimize the frustration and aggression experienced by patients.