Alzheimer's Disease Health Center

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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. Counseling, such as cognitive-behavioral therapy, is also used to treat depression.

For more information , see the topic Depression.

Treating other causes of dementia

Conditions such as high blood pressure (which can lead to multi-infarct dementia), thyroid problems, or Parkinson's disease, also can contribute to dementia in an older person who has Alzheimer's disease. Some of these conditions may respond well to treatment with medicines.

Medication Choices

Medicines used to treat symptoms of mental decline in people who have moderate Alzheimer's disease include cholinesterase inhibitors such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon).

Memantine (Namenda) is a medicine for treating severe symptoms of confusion and memory loss from Alzheimer's disease. It works differently than cholinesterase inhibitors. But, like cholinesterase inhibitors, it does not prevent Alzheimer's disease from progressing. This medicine may cause dizziness, confusion, headache, and/or constipation in some people.

Other medicines may be tried to treat anxiety, agitated or hostile behavior, sleep problems, frightening or disruptive false beliefs (delusions), suspicion of others (paranoia), or hallucinations (seeing or hearing things that aren't there).

What To Think About

Close monitoring and regular reevaluation of the person who has Alzheimer's disease are very important during treatment with medicine. As the disease progresses and symptoms change, the person's medicine needs often change. If you are a caregiver for someone with Alzheimer's disease, be alert for adverse drug reactions or side effects that further impair the person's ability to function.

Before deciding to manage behavior problems with a medicine, try to figure out what is causing the behavior. Understanding why a person is behaving in a certain way can point to better ways of dealing with that behavior. If you are able to find other ways of dealing with behavior problems, you may be able to avoid treatment with medicine and the side effects and costs that come with it.

Doctors don't know for sure that cholinesterase inhibitors help with behavior problems in people who have Alzheimer's disease.⁸ Some studies show that these medicines do help, which can mean less burden on caregivers.⁹ If that burden is reduced, people who have Alzheimer's may be able to live at home longer.

Other studies show that cholinesterase inhibitors do not help with behavior.^{10, 11} But these medicines may still help some people with memory and daily functioning.

Rivastigmine (Exelon) can now be given through a skin patch. Skin patches release medicine into the blood at a steady level and may reduce side effects. And when the person uses a skin patch, it’s easier for caregivers to make sure a person is taking the medicine properly.