A diagnosis of Alzheimer’s can be both devastating and overwhelming for both the patient and their family. Doctors may prescribe different drugs to slow the progression or manage the effects of the disease. It’s helpful to know and understand the medications indicated for the treatment of Alzheimer’s disease.
Around 5.7 million Americans live with Alzheimer’s. That number is expected to increase over time. If Alzheimer’s is affecting you or someone close to you, you need to know your treatment options.
Read on to learn more about how Alzheimer’s is treated.
What is Alzheimer’s Disease?
Alzheimer’s disease is a progressive brain disorder that severely diminishes a person’s memory and cognitive skills. Among older adults, it’s the most common cause of dementia.
As the disease worsens, those who suffer from Alzheimer’s may be unable to carry out even simple tasks. Alzheimer’s is irreversible, but its progression may be slowed with proper treatment.
Most patients have late-onset type Alzheimer’s disease. In this type, symptoms appear first when patients are in their mid-sixties. Rarely, early-onset Alzheimer’s can affect people between their thirties and sixties.
Brain Changes in Alzheimer’s Patients
The brains of Alzheimer’s patients usually present large numbers of abnormal protein clumps. These clumps are referred to as amyloid plaques. They also are riddled with tangled bundles of nerve fibers. These bundles are referred to as neurofibrillary tangles, or tau.
These two features are considered some of the defining characteristics of Alzheimer’s progression in the brain. Additionally, patients present with a loss of connections between neurons in the brain. Neurons are nerve cells that transmit signals from one part of the brain to another. They also transmit signals from the brain and spinal cord to various organs and muscles throughout the body.
It appears that Alzheimer’s damage first begins in the hippocampus. This is the brain area that is crucial for memory formation. Neurons progressively die and damage accumulates in other areas of the brain, shrinking the tissue.
These are the mechanisms that we know of today. It’s likely that there are many other brain changes occurring that aren’t yet understood.
Signs of Alzheimer’s Disease
Alzheimer’s usually progresses slowly, with symptoms and signs becoming more pronounced over time. Initially, a patient may:
- Feel lethargic and have less interest in activities
- Experience short-term memory loss
- Have mild coordination and fine motor skill issues
- Have difficulty concentrating on basic tasks
- Experience mood swings and marked depression
- Have language problems
As the disease progresses, symptoms and behaviors become more pronounced and behaviors become more abnormal. Patients often:
- Are confused about the time of day or their location
- Become upset or angry with little provocation
- Have trouble with using language correctly and have a tendency to ramble
- Have trouble dressing appropriately for the occasion or the weather
- May get lost or wander
- Become delusional or suspicious of caretakers
- Have disturbed sleep patterns
In the last stages of Alzheimer’s, signs and symptoms are severe. These include:
- Major confusion about the present and the past
- Hallucinations
- Severe mood swings
- Inability to remember things, process information, or express themselves
- Difficulty swallowing
- Loss of bladder and bowel control
- Seizures and weight loss
Each of these disease stages usually lasts several years, though this time range varies from patient to patient. Medications for Alzheimer’s may offer some patients relief from symptoms. They may also slow the onset of each stage.
Medications Used in the Treatment of Alzheimer’s
There is currently no cure for Alzheimer’s disease. There are medications, however, that can treat symptoms and delay disease progression in some patients. Medications for Alzheimer’s disease are only part of a support plan. Activities, social support, and assistance with daily needs are essential.
If a doctor believes that treatment for Alzheimer’s is appropriate, certain drugs may be prescribed based on the patient’s age and disease progression.
Cholinesterase Inhibitors
For patients with mild to moderate Alzheimer’s disease, cholinesterase inhibitors are sometimes prescribed. These medications can reduce symptoms and regulate behavioral abnormalities in some patients.
Cholinesterase inhibitors may prevent acetylcholine breakdown in the brain. The chemical acetylcholine is a neurotransmitter that enhances signal transmission across synapses. Synapses are the connections between two neurons that consist of a tiny gap where signals pass from one neuron to the other. Acetylcholine is thought to be important for cognitive ability and memory formation.
Cholinesterase inhibitors prescribed for Alzheimer’s include:
- Aricept® (donepezil)
- Razadyne® (galantamine)
- Exelon® (rivastigmine)
As Alzheimer’s progresses, the brain makes less acetylcholine. With very little acetylcholine present, cholinesterase inhibitors are no longer helpful.
N-methyl D-aspartate Antagonist
For patients with moderate to severe Alzheimer’s disease, another drug is prescribed. This drug is called Namenda® (memantine). Namenda® is an N-methyl D-aspartate antagonist. It is intended to decrease symptoms, possibly allowing some patients to maintain a certain level of independent functioning, including participating in activities of daily living, for several more months.
Namenda® may protect neurons from the excessive amounts of glutamate caused by cells that have been damaged by Alzheimer’s disease.
Combination Drugs and Other Supportive Drugs
Namzaric® is a combination drug. It contains the active ingredients of Namenda® and Aricept®, providing acetylcholine support and neuron protection. This drug comes in capsules that can be opened and added to food for patients who are experiencing swallowing difficulty.
Sometimes Alzheimer’s patients will be prescribed other medications to address the symptoms of the disease. These medications can include:
- Antidepressants
- Anti-convulsants
- Antipsychotics
- Sleep aids
- Anti-anxiety medications
These prescriptions are only given when other safer treatments have not been successful. When mood, behavior, and sleep become more difficult to manage, these may help.
Treatment for Alzheimer’s Disease
While there is no cure for Alzheimer’s disease, there are drugs available that may help with symptoms and slow the speed of deterioration. The symptoms of Alzheimer’s are distressing to the patient and the family, so treatment of Alzheimer’s may offer some relief.
Are you on this overwhelming journey with a loved one and need more support? We are here to make this difficult time easier on everyone involved. For more information on our facilities and how we provide a safe and nurturing environment for those with Alzheimer’s disease, please contact us today.
