There are a few U.S. Food and Drug Administration (FDA) approved drugs to treat people diagnosed with Alzheimer’s Disease (AD). While these drugs may slow the advance of Alzheimer’s Disease, they may have different results for different people. Each person’s disease process is different.
Mild to Moderate Alzheimer’s
Drugs called “cholinesterase inhibitors” are used to treat the early stages of AD. Research indicates that these drugs help prevent acetylcholine, a brain chemical important for memory and thinking, from breaking down. The drugs often have positive results for a limited time, helping to control behavioral symptoms resulting from the disease. As the disease progresses, the brain produces less acetylcholine, so the drugs have less effect. Drugs used at this stage in the disease are:
- Razadyne (formerly Reminyl) – prevents acetylcholine breakdown and stimulates nicotinic receptors to release more acetylcholine.
Common side effects: weight loss, diarrhea, vomiting and nausea.
Manufacturer’s recommended dosage: inital dose of 8 mg/day (4mg twice a day); may increase dose to 16 mg/day (8mg twice a day) and 24mg/day (12 mg twice a day) at minimum 4-week intervals if well tolerated.
- Exelon (rivastimine) – works to prevent the breakdown of acetylcholine and butyrylcholine (another brain chemical.
Common side effects: weakness, weight loss, diarrhea, vomiting and nausea.
Manufacturer’s recommended dosage: capsule – initial dose of 3 mg/day (1.5 mg twice a day); may increase dose to 6 mg/day (3 mg twice a day), 9 mg/day (4.5 mg twice a day), and 12 mg/day (6 mg twice a day) at minimum 2-week intervals if well tolerated. Patch – initial dose of 4.6 mg once a day; may increase to 9.5 mg once a day after minimum of 4 weeks if well tolerated. Exelon is also available as an oral solution with the same dosage as the capsule.
- Aricept (donepezil) – helps prevent the breakdown of acetylcholine.
Common side effects: diarrhea, vomiting and nausea.
Manufacturer’s recommended dosage: initial dose of 5 mg once a day; may increase to 10 mg/da6 after 4-6 weeks if well tolerated.
Moderate to Severe Alzheimer’s
Namenda (memantine), an N-methyl D-aspartate (NMDA) antagonist, is often used for moderate to severe AD. Namenda’s main effect is to delay progression of disease symptoms. Some patients may be able to better perform particular daily functions a while longer with Namenda.
- Namenda (memantine) – blocks the toxic effects associated with excess glutamate and regulates glutamate activation.
Common side effects: confusion, constipation, headache and dizziness.
Manufacturer’s recommended dosage: initial dose is 5 mg once per day; may increase dose to 10 mg/day (5 mg twice a day), 15 mg/day (5 mg and 10 mg as separate doses), and 20 mg/day (10 mg twice a day) at minimum 1-week intervals if well tolerated.
With all drugs, doctors usually start patients at low doses and gradually increase the dosage depending on how the patient responds to the drug’s effects. The higher the dose, the more likely side effects will occur. Patients should be closely monitored when the drug is started.
Information for this post was derived from the National Institute on Aging’s “Alzheimer’s Disease Medication Fact Sheet” and should in no way serve as medical advice. Always consult your doctor.
