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Alzheimer's disease-mental problems

At this time, there are no medicines that can prevent or cure Alzheimer's disease or that will restore normal mental abilities. Medicine may help some people function better by temporarily reducing memory loss and thinking problems. Other medicines may be needed to treat associated conditions, such as depression.

Improving memory and daily functioning

Medicines include donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). These medicines, called cholinesterase inhibitors, have been approved specifically for treatment of Alzheimer's disease. Research suggested that people with moderate to severe Alzheimer's disease who took cholinesterase inhibitors experienced improvement in thinking and daily functioning when they added memantine (Namenda) to their treatment.

All these medicines may temporarily help improve memory and daily functioning in some people who have Alzheimer's disease. The improvement varies from person to person. These medicines do not prevent the disease from getting worse, although they may slow down mental decline.

The main decision about using medicines to treat failing mental function usually is not whether to try a medicine but when to begin and, later, when to stop treatment. Medicine treatment can be started as soon as Alzheimer's disease is diagnosed. But the person may or may not significantly improve when taking medicines because they do not work for everyone. If the medicines are effective, they are continued until the side effects outweigh the benefits or until the person no longer responds to the medicines.

Treating behavior problems

Sometimes, medicine may be used to manage behaviors or symptoms that are causing strain for the person with Alzheimer's disease and his or her caregivers. Medicines generally are used only when other treatments have failed. For example, if the person still has trouble sleeping after trying regular exercise and avoiding naps, a medicine may be needed.

When it comes to disruptive behaviors, caregivers are encouraged to try to understand the reasons for the behaviors and to develop other ways to manage them whenever possible. Distracting the person, avoiding situations that seem to cause the behavior, and using good communication often can help limit these behaviors.

Although other approaches to managing behaviors should always be tried first, medicines such as tranquilizers may be needed if:

    * A behavior is severely disruptive or harmful to the person or to others.
    * Efforts to manage or reduce disruptive behavior by making changes in the person's environment or routines have failed.
    * The behavior is making the situation intolerable for the caregiver.
    * The person has trouble telling the difference between what is and is not real (psychosis) in addition to dementia. Psychosis causes the person to have false beliefs (delusions) and to hear or see things that are not there (hallucinations).

Treating depression

Depression occurs in close to half of people who have Alzheimer's disease. It is especially common during the early stages of the disease when a person may be aware of losing his or her ability to think and function independently. Antidepressants can relieve symptoms of depression and may improve quality of life, although they will not slow down the progression of Alzheimer's disease.