Antianxiety medications can help reduce anxiety in people living with dementia. Dementia refers to a range of conditions that affect a person’s memory, ability to think, and decision-making abilities.
The
Treating Alzheimer’s disease and other forms of dementia typically involves treating the symptoms and the disease itself. People living with dementia may experience anxiety, which a doctor may treat with medication.
Caregivers should consider taking an active role in helping administer medications. This can help keep a person with dementia on track regarding taking the correct medications.
The Alzheimer’s Association states that doctors may prescribe lorazepam and oxazepam to treat anxiety. They also mention that doctors prescribe these off-label. This means that these medications did not originally have approval for treating anxiety in those with dementia.
This article reviews medications typically available to treat anxiety in people living with dementia.
The following table outlines the medications that can help treat anxiety in those with dementia.
| Brand name | Generic name | Dose | Side effects |
|---|---|---|---|
| Ativan | lorazepam | • sedation • dizziness • physical weakness or a lack of energy • difficulties with coordination, speech, and balance • respiratory depression • low blood pressure • fatigue • difficulties with memory • confusion • a loss of inhibitions • irritability • changes to sex drive • seeing double • changes to appetite • constipation • incontinence • urinary retention • muscle spasms and contractions | |
| Serax | oxazepam | starting doses 10–15 mg every 6–8 hours for moderate anxiety 15–30 mg every 6–8 hours for severe anxiety 10–15 mg orally three or four times daily for older adults | • sedation • memory impairment • fatigue • depression • dizziness • nervousness • difficulties with speech, balance, and coordination • slurred speech • hyper-excitability • weakness |
| Xanax | alprazolam | common doses 0.25 to 0.5 mg three times a day for adults 0.25 mg two or three times a day for older adults | • constipation • drowsiness • balance or coordination issues • dizziness • insomnia • memory problems • irritability • slurred speech • appetite or weight changes • decreased mental alertness • diarrhea • tiredness • trouble concentrating • increased sweating • headache • nausea • vomiting • upset stomach • worsening depression • blurred vision • hypomania • swelling of hands or feet • muscle weakness • dry mouth • stuffy nose • loss of interest in sex |
Lorazepam is a type of benzodiazepine. Doctors prescribe it for its positive effect on anxiety and its sedative effects.
Benzodiazepines
How to take
A person should follow all instructions from the doctor when taking lorazepam. For anxiety, the starting dose is
However, they should never exceed 10 mg per day.
Side effects
- sedation
- dizziness
- physical weakness or a lack of energy
- difficulties with coordination, speech, and balance
- respiratory depression, which refers to a slow or shallow breathing rate
- low blood pressure
- fatigue
- difficulties with memory
- confusion
- a loss of inhibitions
- irritability
- changes to sex drive
- seeing double
- changes to appetite
- constipation
- incontinence
- urinary retention
- muscle spasms and contractions
If a person is taking lorazepam, they should avoid:
- alcohol
- muscle relaxing medications
- cold medications
- opioids
- sleeping pills
It is also not suitable for those who are pregnant.
Oxazepam is a type of benzodiazepine that doctors can use to treat anxiety. It is a short-acting medication, which means it starts working rapidly once a person takes it. Its effects are typically short, with a half-life — the time it takes for a drug’s active substance to reduce by half in the body — of between
How to take
Though doses can vary,
- moderate anxiety: 10–15 mg orally every 6 to 8 hours
- severe anxiety: 15–30 mg orally every 6 to 8 hours
- older adults: 10–15 mg orally three or four times daily
Side effects
Like other anxiety medications, a person may experience several potential side effects when taking oxazepam. These
- sedation
- memory impairment
- fatigue
- depression
- dizziness
- nervousness
- difficulties with speech, balance, and coordination
- slurred speech
- hyper-excitability
- weakness
Less frequently, a person may experience other side effects that can include:
- jaundice
- low blood pressure
- incontinence
- mania
- dry mouth
- swelling
- hallucinations
- a low white blood cell count
- decreased libido
- double vision
- rash
- menstrual irregularities
Oxazepam can also lead to severe rash, irregular heartbeat, and constant fever.
It can increase the risk of breathing problems if a person combines it with other medications that contain opiates and codeine.
Alprazolam is the
How to take
Though dosing can vary, the following
Side effects
Alprazolam can cause various side effects. They
- constipation
- drowsiness
- balance or coordination issues
- dizziness
- insomnia
- memory problems
- irritability
- slurred speech
- appetite or weight changes
- decreased mental alertness
- diarrhea
- tiredness
- trouble concentrating
- increased sweating
- headache
- nausea
- vomiting
- upset stomach
- worsening depression
- blurred vision
- hypomania, when a person experiences elevated and extreme changes to their mood, emotions, energy levels, or activity levels
- swelling of the hands or feet
- muscle weakness
- dry mouth
- stuffy nose
- loss of interest in sex
People should speak with a doctor if they experience any of the above side effects. They should also seek immediate medical attention if they experience:
- forgetfulness
- difficulty with coordination
- feelings of constant discouragement
The following may be alternative medications to help treat anxiety in those with dementia.
Antidepressants
The Alzheimer’s Association notes that depression is very common in those with dementia. A doctor may prescribe antidepressants if they suspect that depression is causing a person with dementia to experience anxiety.
Buspirone (BuSpar)
Buspirone is a form of anxiolytic drug that health experts originally developed for psychosis. It is a type of azapirone and typically binds to the serotonin 5HT1a receptors, which helps produce a calming effect. It also has fewer side effects compared with other anxiety medications.
While buspirone does not have approval, researchers
Medication can be expensive. In addition to anxiety medication, a person with dementia will also need additional medications to treat other symptoms and help slow the progression of the disease.
A person can speak with a doctor or pharmacist to explore the most affordable options. They can also see if they have any information on prescription saving plans.
Individuals can also contact several organizations that can help connect them with prescription discounts.
These organizations can include:
- RxOutreach, a nonprofit mail order pharmacy that aims to offer access to affordable medications
- RxHope, which aims to help make the patience assistance programs simpler to navigate
- PAN Foundation, an organization that aims to help people with the out-of-pocket costs of prescription medications
- BlinkHealth, which offers discounted prescription prices
- GoodRx, which aims to help people compare prices online for prescription medications
- NeedyMeds, a nonprofit that connects people to programs that help with the cost of medications
- Medicine assistance tool, a search engine that can help people learn more about the resources available to them
- PharmacyChecker, which helps compare prescription drug prices
- Medicare and Medicaid
Several medications, including lorazepam and oxazepam, can help treat anxiety in people with dementia. These drugs are examples of benzodiazepines.
A person should take the medications as a doctor prescribes and speak with a healthcare professional if they experience any adverse effects.
Someone who has difficulties paying for their prescriptions may be eligible for help from discount programs or coupons that can help cover the costs.