How Does Alzheimer’s Medication Work?

Alzheimer’s disease is a brain disorder that causes cognitive decline and makes carrying out daily tasks challenging. It affects more than 6 million Americans over the age of 65.

What Is Alzheimer’s Disease? 

Alzheimer’s disease is a neurological condition that causes dementia and severe cognitive decline. It affects your memory, the way you think, your ability to learn new things, and even your ability to carry out everyday tasks.

How Does Alzheimer's Medication Work? 

Current treatment options for Alzheimer’s disease focus on reducing the severity of its symptoms and helping a person with the condition live a functioning life. 

There are two major classes of drugs used to slow cognitive decline in people with Alzheimer’s— cholinesterase inhibitors and NMDA receptor antagonists.

There are also drugs used to treat the symptoms of Alzheimer's disease such as depression and anxiety.

Cholinesterase Inhibitors 

Cholinesterase inhibitors are a group of drugs approved by the FDA to treat dementia, which is characterized by cognitive decline in people who have Alzheimer’s disease. These medications work by preventing the breakdown of acetylcholine.

Acetylcholine is a chemical messenger that helps the nerves in your brain communicate effectively. There have been mixed results on the effectiveness of these drugs. Where improvement was noticed, it has been described as modest.

The most common cholinesterase inhibitors prescribed for the treatment of Alzheimer’s disease are:

• Razadyne (galantamine)
• Exelon (rivastigmine)
• Aricept (donepezil)

Some mild side effects you might experience while using these drugs include nausea, diarrhea, vomiting, and lightheadedness. 

NMDA Receptor Antagonists

Namenda (memantine) is the only NMDA (n-methyl-D-aspartate) antagonist approved by the FDA to treat Alzheimer’s disease. It works by blocking a chemical messenger called glutamate from firing up the NMDA receptors on nerve cells in your brain. This helps to prevent damage to the brain cells and keep them healthy.

Studies show that memantine effectively slows cognitive decline in people with severe or late-stage Alzheimer’s disease. It’s also prescribed for people who react adversely to cholinesterase inhibitors. Some mild side effects you might experience while using this medication include constipation, dizziness, and headaches. However, these will pass with time.

Cholinesterase inhibitors and memantine are typically prescribed together. Some research shows that people with Alzheimer’s respond better to a combination of these drugs than they do to only cholinesterase inhibitors. In 2014, a capsule combining both drugs was approved by the FDA to treat Alzheimer’s.

Aduhelm 

Aduhelm is a newer treatment for Alzheimer’s disease still undergoing trials. It has been touted as an edge-cutting Alzheimer’s drug that could potentially prevent the condition from developing.

Current research into the effectiveness of Aduhelm has come up with mixed results. While some show promise of the drug improving brain function, others seem to show little to no result. 

Treatments That Treat Symptoms 

While cholinesterase inhibitors and NMDA receptor antagonists focus on slowing cognitive decline, there are other medications available for treating psychological and behavioral symptoms of Alzheimer’s disease; they include:

• Antidepressants: Antidepressants are typically prescribed to help with behavioral symptoms of Alzheimer’s, such as depression and anxiety. Anti-anxiety drugs could also be prescribed for the same purpose. 
• Anticonvulsants: In people with severe symptoms of aggression, anticonvulsants such as Neurontin (gabapentin) and Lyrica (pregabalin) might be prescribed.
• Antipsychotics: Hallucinations, delusions, and paranoia are characteristic of later stages of Alzheimer’s disease. In these cases, antipsychotics such as Seroquel (quetiapine) and Risperdal (risperidone) may be prescribed to reduce the severity of these symptoms. However, antipsychotics are often accompanied by bothersome side effects such as confusion. Your doctor will only prescribe them if your symptoms are severe and, even then, will try to keep the prescription duration short. 
  

What Happens If You Stop Taking Your Alzheimer’s Medication?

You shouldn’t stop taking your Alzheimer’s medication without your doctor’s go-ahead. In many cases, when you suddenly stop taking the prescription medication, your symptoms may worsen, and you may experience additional withdrawal symptoms from stopping the drug abruptly.

Drugs aimed at slowing cognitive decline can have severe side effects. Doctors have also questioned its long-term use and sometimes advise that you stop taking these medications after a short term. However, dementia is a constant struggle in people with Alzheimer’s, and researchers have begun to look into the benefits of taking anti-dementia drugs for longer periods.

In a 2021 scientific review, researchers found it more beneficial to continue taking cholinesterase inhibitors at all stages of Alzheimer’s disease than to stop the medication.

Can You Become Addicted to Alzheimer’s Medication?

While there is some evidence to suggest that drug and alcohol abuse can trigger the development of Alzheimer’s in some people, there’s no evidence to suggest Alzheimer’s medication can cause addiction.

Frequently Asked Questions