Currently there is not a medication available to prevent or cure Alzheimer's disease. The goal of medication therapy is to treat the symptoms versus cure the disease. Medications help the person maintain comfort, dignity and independence and help slow the progression of the disease by approximately 3-6 months.
There are two classes of drugs used for disease management they are called Cholinesterase Inhibitors and NMDA Antagonist. Below is an overview of how these medications work, and their most common side effects. This overview is designed to help you and your loved one make an educated decision related to deciding whether or not Alzheimer's disease medications are right for you or your loved one.
Mild to Moderate Alzheimer's disease
Early to Middle stage Alzheimer's disease is treated with a group of medications called Cholinesterase Inhibitors. Alzheimer's disease damages cells that produce and use acetylcholine, a chemical in the brain that is responsible for carrying messages from one brain cell to another. Once the message is received by the intended brain cell, another chemical called acetylchoinesterase breaks down acetylcholine so that it can be recycled. Cholinesterase Inhibitors slows the action of the acetylcholininesterase which helps maintain the amount of acetylcholine in the brain. Because the production of acetylcholine is naturally decreased in the aging brain, these medications only work for a short time, providing benefit to the person with Alzheimer's disease for only 3-6 months.
The following is a list of the three commonly prescribed Cholinesterase Inhibitors. Both the trade name and generic name have been provided (generic name is in parentheses):
- Razadyne (galantamine)
- Exelon (rivastigmine)
- Aricept (donepezil)
Common side effects of Cholinesterase Inhibitors are nausea, vomiting, diarrhea, loss of appetite and weight loss. The doctor most often starts these medications at a low dose and slowly increases dosage to help avoid side effects. Often, side effects diminish after taking the medication for a few weeks. If you or your loved one's side effects do not go away or become too severe to manage notify your doctor.
Moderate to Severe Alzheimer's Disease
A medication known as Namenda (memantine) is used to treat moderate to severe Alzheimer's disease. Namenda helps manage some of the symptoms of Alzheimer's disease related to function. It allows the person to maintain certain daily functions, such as the ability to use the bathroom a little longer than they would without the medication. Namenda is classified under a group of drugs called NMDA Antagonist.
NMDA Antagonist are thought to work by regulating glutamate an important brain chemical that helps strengthen the connections or synapses between brain cells. When excessive glutamate is produced it leads to brain cell excitability and
cell death. NMDA Antagonist block the NMDA receptor and prevent it from binding with too much glutamate and slowing down the cell death that occurs as a result of Alzheimer's disease.
Namenda comes in 5 mg and 10 mg tablets or capsules. Most doctors start with the 5 mg dose to help prevent side effects. Most commonly reported sided effects are dizziness, headache, constipation and confusion.
NMDA Antagonist and Cholinesterase Inhibitors work in very different ways allowing them to be used in combination for the management of symptoms related to Alzheimer's Disease.
Medications used to treat Alzheimer's Disease can help reduce symptoms and progression of the disease by approximately 3-6 months. At this time, there is no cure for Alzheimer's disease. The decision to use one of the available medications is dependent on the preferences of the person with the disease and his or her family. Some may feel that the side effects are not worth the small
difference that these medications can make. Other families feel that if these medications can help even a little bit they are worth trying. Only you and your loved one can make the decision that is right for you.
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