There is currently no cure for Alzheimer’s disease. However, many people with Alzheimer’s can improve their symptoms and quality of life with effective treatments.
The symptoms and severity of Alzheimer’s disease can vary widely between individuals. There is no standard treatment for this condition. Your doctor will recommend an Alzheimer’s treatment plan based on several factors:
There are now more treatments for Alzheimer’s than ever before. Some medications treat the underlying causes of the condition, while others help manage the symptoms.
Aduhelm (aducanumab), which became available in the U.S. in 2021, is the only drug approved by the U.S. Food and Drug Administration (FDA) to treat the underlying cause of Alzheimer’s. Aduhelm is an antibody treatment that reduces amyloid plaques (abnormal protein buildups) in the brain and may slow the progression of Alzheimer’s in some cases. This drug, which is a monthly injection, can be extremely expensive. It has only been studied in people with earlier stages of the disease, and it is unclear whether it would be helpful for people with later stages of Alzheimer’s. Potential side effects include headache, increased fall risk, allergic reaction, and bleeding or temporary swelling in the brain.
There are five medications approved by the FDA to treat dementia (cognitive decline and memory loss) in Alzheimer’s disease.
Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine) can be prescribed for mild to moderate Alzheimer’s symptoms. All three medications are members of a drug class called cholinesterase inhibitors. They are believed to work by regulating the amount of acetylcholine — a neurotransmitter — in the brain.
Namenda (memantine) is an N-methyl-D-aspartate (NMDA) receptor antagonist that regulates a neurotransmitter called glutamate.
Namzaric (donepezil/memantine) is a combination of medications from both of these classes. Namenda and Namzaric can be prescribed for moderate to severe Alzheimer’s symptoms.
Nausea, vomiting, loss of appetite, and diarrhea are common symptoms of these five drugs specifically approved to treat Alzheimer’s dementia.
As Alzheimer’s disease progresses, behaviors such as aggression, wandering, nighttime restlessness, and sleep disturbances often emerge. These behaviors can be dangerous to the person with Alzheimer’s as well as burdensome for caretakers.
Many caretakers try nondrug strategies first before resorting to medications. This is because medications may cause side effects that worsen some Alzheimer’s symptoms.
Here are some nondrug strategies caretakers can try to minimize difficult behaviors:
If nondrug strategies fail, some medications can soothe people with Alzheimer’s, help them sleep, or prevent dangerous behaviors. There are several classes of drugs that can help reduce behavioral disturbances. Each class of medications can also cause side effects. Work with your doctor or health care team to determine which medications will be safest and most effective.
Antidepressants are sometimes prescribed off-label to improve depression and anxiety and reduce behavioral problems for those who have Alzheimer’s. These include Celexa (citalopram), trazodone, and Zoloft (sertraline). Antidepressant side effects differ, but the most common include nausea, drowsiness, and weight gain.
Antipsychotics, such as Seroquel (quetiapine), Risperdal (risperidone), Haldol (haloperidol), and Abilify (aripiprazole), may be prescribed at low doses to reduce severe agitation, aggression, and psychotic symptoms. Antipsychotics are believed to work by interfering with serotonin receptors in the brain.
Antipsychotics can cause serious side effects, including slowed movement, tremor (shakiness), loss of balance, and muscle stiffness. Antipsychotics can increase the risk of stroke or death for older people with dementia, so it is very important to work closely with a specialist if they are prescribed.
Benzodiazepines, such as Ativan (lorazepam) and Klonopin (clonazepam), are sedatives that are sometimes prescribed short-term to help with agitation in Alzheimer’s disease. Benzodiazepines can increase confusion and cause dizziness, raising the risk for falls.
Sleep aids are sometimes used to treat sleep problems in those with Alzheimer’s, but many doctors recommend against this usage. Belsomra (suvorexant) is the only insomnia medication approved by the FDA to treat sleep disturbances in people living with mild to moderate Alzheimer’s. Side effects include sleep paralysis, impaired motor skills, and depression. Sleep aids such as Ambien (zolpidem), Lunesta (eszopiclone), and Sonata (zaleplon) can increase the risk of falls and confusion in people with Alzheimer’s.
Many products are marketed as “natural” or “holistic” treatments for Alzheimer’s, but no natural, alternative treatments have been proven in clinical studies to delay or prevent disease progression.
While there have been no clinical trials to study medical marijuana and people with Alzheimer’s, some people have used it to manage behavioral symptoms such as mood problems and sleep disorders. Depending on symptoms, one strain of medical cannabis may provide more benefits than another. Always ask your doctor before trying any new alternative treatments.
High doses of supplementary vitamin E, which may slow disease progression, may be prescribed. It is important to note that dietary supplements are not tested by the FDA for quality or purity. Always let your doctor know before trying any new supplements. Even over-the-counter vitamins can interfere with prescribed medications.
Exercise has been proven in multiple studies to be highly beneficial for people with Alzheimer’s. Regular exercise can improve sleep, mood, appetite, and self-esteem, and reduce the risk for cancer, heart disease, and other illnesses. Exercise can also slow the rate of functional decline and reduce the risk of falls by improving balance and coordination.
Regular exercise does not necessarily mean going to the gym or playing sports. Look for a physical activity that increases the heart rate and encourages deep breathing. Walking can be a good option. Those with trouble walking may try chair exercises, stationary bicycles, and stretching. Ask your doctor about appropriate activities for your abilities.
While there is no special diet for people with Alzheimer’s, proper nutrition and hydration can improve behavioral symptoms and help prevent weight loss.
Eating can become more difficult for people with Alzheimer’s as the disease progresses. Visual changes, declining physical function, distractibility, and loss of appetite can make mealtimes challenging. By following certain guidelines — such as limiting mealtime distractions and allowing plenty of time to eat — caregivers can help keep food appealing and ensure as much independence as possible.
Depending on several factors, you may be eligible to participate in clinical trials studying new treatments for Alzheimer’s. Talk to your health care provider about which options may be available.
Clinical trials may test new drugs, new procedures, new dosages of existing drugs, or new combinations of existing drugs. Clinical trials may also research the impact of exercise, nutrition, or dietary supplements on quality of life or the course of the disease. You can withdraw from a clinical trial at any time.
On myALZteam, the social network for people with Alzheimer’s and their loved ones, more than 83,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.
Are you living with Alzheimer’s? Which treatments have helped you? Share your experience in the comments below, or start a conversation by posting on your Activities page.