Some cases of dementia are caused by medical conditions that can be treated, fully or partly restoring mental function. When dementia cannot be reversed, the goal of treatment is to make life as easy as possible for the person and the caregivers.

Initial treatment

If the cause of dementia can be reversed, the doctor will prescribe treatment. For example, the person might:

• Take vitamins for a deficiency of vitamin B12.
• Take thyroid hormones for hypothyroidism.
• Have surgery to remove a brain tumor or to reduce pressure on the brain.
• Stop or change medicines that are causing memory loss or confusion.
• Take medicines to treat an infection, such as encephalitis, that is causing changes in mental state.
• Take medicine to treat depression.
• Get treatment for reversible conditions caused by AIDS.

After treatment for reversible conditions, the person will continue to see his or her doctor to make sure the symptoms do not return.

For people with vascular dementia, doctors may prescribe medicines to lower high blood pressure and medicines for high cholesterol (statins). These drugs cannot reverse existing dementia, but they may prevent future strokes and heart disease that can lead to further brain damage.

If the cause of dementia cannot be treated, the doctor will work with the person and caregivers to develop a plan to make life easier and more comfortable. Care plans may include tips to help the person be independent and manage daily life as long as possible. Education of the family and other caregivers is critical to successfully caring for a person with dementia. If you are or will be a caregiver, start learning what you can expect and what you can do to manage problems as they arise. For more information, see the Home Treatment section of this topic.

While medicines cannot cure dementia, they may help improve mental function, mood, or behavior. Medicines that your doctor may prescribe include:

• Cholinesterase inhibitors such as donepezil (Aricept), galantamine (Reminyl), or rivastigmine (Exelon), to improve or maintain mental function. These drugs were developed to treat Alzheimer's disease, but they may be tried in other dementias. Recent studies indicate that they hold promise for the treatment of people with vascular dementia. Both donepezil and galantamine have been shown to improve mental function with few side effects.^{10, 11} Rivastigmine may help people with dementia with Lewy bodies and Parkinson's disease, but side effects such as nausea, vomiting, and weight loss are common.¹² At present, medicines can slow but not stop the progress of dementia.
• Memantine (Namenda). This type of medicine can slow the late stages of Alzheimer's disease. It may also benefit those with mild to moderate vascular dementia.^{13, 12} More studies are under way.
• Antidepressants to treat depression. They must be used carefully because they can cause delirium in people with dementia. Antidepressants that have the fewest side effects in people with dementia are SSRIs, such as fluoxetine (Prozac, for example) and citalopram (Celexa).¹⁴
• Medicines to ease anxiety, agitation, aggression, and hallucinations. Some of these medicines, called antipsychotic drugs, are not approved by the FDA for the treatment of dementia. Studies of people with psychosis due to dementia who were treated with these medicines, including Zyprexa and Risperdal, found an increased risk of death.^{15, 16} Discuss this risk with your doctor before using these medicines.