What is the best medication for dementia?

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Currently, there is no cure for Alzheimer’s disease. However, treatment can help improve a person’s quality of life and, in some cases, slow the progression of the disease.

For mild to moderate Alzheimer’s disease symptoms, doctors often prescribe a group of drugs called cholinesterase inhibitors. This category includes the medications galantamine, rivastigmine, and donepezil.

They work by stopping the breakdown of acetylcholine, a chemical in the brain that plays an important role in memory and thinking. However, they cannot slow the progression of the disease.

Only one drug, aducanumab, may target the underlying cause of the disease and slow its progression. A doctor may prescribe this medication in the early stages of Alzheimer’s disease.

In 2021, the Food and Drug Administration (FDA) provided accelerated approval for aducanumab. Researchers are currently testing other medications to help treat pre-Alzheimer’s disease.

The table below provides information on some common medications for Alzheimer’s disease. The information is from the National Institute on Aging.

Dosages of each medication vary based on a person’s need. A doctor will likely start a person on a smaller dose and then increase the dose depending on how the person responds to the drug. Higher doses are more likely to cause side effects.

Aducanumab is currently the only disease-modifying medication for Alzheimer’s disease.

The medication is a type of immunotherapy that targets the protein beta-amyloid and helps reduce amyloid plaques. Amyloid plaques are brain lesions associated with Alzheimer’s disease. Reducing these plaques might help slow the rate of cognitive decline.

When testing the medication, researchers looked at how it worked for people with early stages of Alzheimer’s disease with mild cognitive impairment. Researchers are currently looking at how it can affect people with moderate to severe cognitive impairments.

It can cause side effects such as:

• ARIA — swelling in one part of the brain that likely will not cause symptoms but can become serious
• headache
• falls
• allergic reaction

Most medications focus on helping reduce the severity of symptoms a person experiences. Often, a person will need several medications to help with their symptoms.

Galantamine (Razadyne)

Galantamine, brand name Razadyne, is a cholinesterase inhibitor. It helps stop the breakdown of acetylcholine. It also helps stimulate nicotinic receptors to release more acetylcholine in the brain.

Doctors prescribe it for mild to moderate dementia associated with Alzheimer’s disease.

It can cause side effects such as:

• vomiting
• nausea
• loss of appetite
• increased frequency of bowel movements
• diarrhea

Donepezil (Aricept)

Donepezil, brand name Aricept, is a cholinesterase inhibitor. A doctor may prescribe it for mild to severe cases of Alzheimer’s disease.

It can cause side effects such as:

• weight loss
• nausea
• muscle cramps
• diarrhea
• fatigue
• vomiting

Rivastigmine (Exelon)

Rivastigmine, brand name Exelon, is a type of cholinesterase inhibitor. Like other medications of this type, it prevents the breakdown of acetylcholine in the brain. Rivastigmine also breaks down butyrylcholine, a chemical similar to acetylcholine.

A doctor may prescribe it for mild to severe forms of Alzheimer’s disease.

It can cause side effects such as:

• nausea
• muscle weakness
• indigestion
• vomiting
• weight loss
• diarrhea

Memantine (Namenda)

Memantine, brand name Namenda, is a type of N-methyl D-aspartate (NMDA) antagonist. This type of medication works in two ways: It regulates activation of glutamate and stops toxic effects associated with excess glutamate.

Doctors may prescribe it for moderate to severe forms of Alzheimer’s disease.

It can cause side effects such as:

• confusion
• dizziness
• headache
• diarrhea
• constipation

Memantine and donepezil combination (Namzaric)

One medication combines memantine and donepezil into one formula. This combination helps block both the toxic effects of glutamate and the breakdown of acetylcholine in the brain.

Doctors may prescribe it for moderate to severe cases of Alzheimer’s disease.

It can cause side effects such as:

• loss of appetite
• headache
• diarrhea
• nausea
• vomiting
• dizziness

Insurance providers may cover medications for dementia. If a person has Medicare, private insurance, or an employee health plan, they may receive help with some of the treatment costs.

Low cost options may be available for people without insurance who have trouble paying for dementia medications.

A person can try to contact a drug company directly to ask about reduced-price options.

The following table displays some drug manufacturers’ telephone numbers. A person may wish to contact the manufacturers to ask about low cost options.

Additionally, several prescription programs exist that may help with costs.

A person can contact some of the organizations below to find out whether they may be eligible for financial help.

A person can also try asking their doctor or pharmacist for help getting the most affordable medications that will fit their needs.

Find out more about Medicare and dementia.

Medication for dementia care does not cure the most common form of dementia, Alzheimer’s disease. However, it can help reduce the effects of the symptoms.

Currently only one drug, aducanumab, can help slow the progression of the disease.

A person who needs help with their medication costs can try to contact the drug company directly or look into one of several nonprofit organizations that may help with prescription costs.