Although current medications cannot cure Alzheimer’s or stop it from progressing, they may help lessen symptoms, such as memory loss and confusion, for a limited time.

Types of Drugs

The U.S. Food and Drug Administration (FDA) has approved two types of medications — cholinesterase inhibitors (Aricept, Exelon, Razadyne) and memantine (Namenda) — to treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer's disease.

As Alzheimer’s progresses, brain cells die and connections among cells are lost, causing cognitive symptoms to worsen. While current medications cannot stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among the brain's nerve cells. Doctors sometimes prescribe both types of medications together.

Medication safety

Before beginning a new medication, make sure your physician and pharmacist are aware of all medications currently being taken (including over-the-counter and alternative preparations). This is important to make certain medications will not interact with one another, causing side effects.

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Medications for early to moderate stages

All of the prescription medications currently approved to treat Alzheimer's symptoms in early to moderate stages are from a class of drugs called cholinesterase inhibitors. Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes.

Additionally, cholinesterase inhibitors:

  • Prevent the breakdown of acetylcholine (a-SEA-til-KOH-lean), a chemical messenger important for learning and memory. This supports communication among nerve cells by keeping acetylcholine high.
  • Delay or slow worsening of symptoms. Effectiveness varies from person to person.
  • Are generally well-tolerated. If side effects occur, they commonly include nausea, vomiting, loss of appetite and increased frequency of bowel movements.

Three cholinesterase inhibitors are commonly prescribed:

  • Donepezil (Aricept) is approved to treat all stages of Alzheimer's.
  • Rivastigmine (Exelon) is approved to treat mild to moderate Alzheimer's.
  • Galantamine (Razadyne) is approved to treat mild to moderate Alzheimer's.

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Medications for moderate to severe stages

Memantine (Namenda) and a combination of memantine and donepezil (Namzaric) are approved by the FDA for treatment of moderate to severe Alzheimer’s.

Memantine is prescribed to improve memory, attention, reason, language and the ability to perform simple tasks. It can be used alone or with other Alzheimer’s disease treatments. There is some evidence that individuals with moderate to severe Alzheimer’s who are taking a cholinesterase inhibitor might benefit by also taking memantine. A medication that combines memantine and a cholinesterase inhibitor is available.

Memantine:

  • Regulates the activity of glutamate, a chemical involved in information processing.
  • Improves mental function and ability to perform daily activities for some people..
  • Can cause side effects, including headache, constipation, confusion and dizziness.

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How Alzheimer's medications work

To understand how Alzheimer's medications work, you first need to understand the communication network in the brain. The picture below depicts nerve cells, or neurons, in the brain. Neurons are the chief cells destroyed by Alzheimer's disease.



In the brain, neurons connect and communicate at synapses, where tiny bursts of chemicals called neurotransmitters carry information from one cell to another. Alzheimer's disrupts this process, and eventually destroys synapses and kills neurons, damaging the brain's communication network.
 

Future treatment breakthroughs

Clinical trials

Find out more about participating in a clinical trial through the Alzheimer's Association TrialMatch® service — a free tool for people with Alzheimer's, caregivers, families and physicians to locate clinical trials based on personal criteria (diagnosis, stage of disease) and location.

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Researchers are looking for new ways to treat Alzheimer's. Current medications help mask the symptoms of Alzheimer's, but do not treat the underlying disease or delay its progression. There are several promising drugs in development and testing, as researchers strive to discover a breakthrough to treat the underlying disease and stop or delay the cell damage that eventually leads to the worsening of symptoms. However, we need more volunteers to complete clinical trials of those drugs and increased federal funding of research to ensure that fresh ideas continue to fill the pipeline. Trials are recruiting people with Alzheimer's and mild cognitive impairment (MCI), as well as healthy volunteers to be controls.

Treatments-at-a-glance

Generic Brand Approved For Side Effects
Donepezil Aricept All stages Nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Galantamine Razadyne Mild to moderate Nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Memantine Namenda Moderate to severe Headache, constipation, confusion and dizziness.
Rivastigmine Exelon Mild to moderate Nausea, vomiting, loss of appetite and increased frequency of bowel movements.
Memantine + Donepezil Namzaric Moderate to severe Nausea, vomiting, loss of appetite, increased frequency of bowel movements, headache, constipation, confusion and dizziness.