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Alzheimer's disease health centre

Dementia - What treatments work for dementia?

BMJ Group Medical Reference

There's no cure for Alzheimer's disease and many other kinds of dementia. But there are several treatments that can help with symptoms such as forgetfulness and confusion. There are also drugs that can help people in the later stages of dementia who become easily upset or aggressive, or who have hallucinations (they see things that aren't there).

alzheimer-carers_default.jpgBut drug treatments are only a part of the care that people with dementia and their families need.

If you're looking after someone with dementia, there will be times when you feel exhausted, angry, or depressed. You will need information about the disease, advice on how to cope, and practical support. Make sure you get help, whether from your family, from professionals, or from groups that help carers.

There are many local carers' groups that may be able to give you the support you need. You can contact the Alzheimer's Society (http://www.alzheimers.org.uk) and Alzheimer Scotland (http://www.alzscot.org) for advice about the kind of help you need.

Key points for treating dementia

  • The drugs donepezil, galantamine, rivastigmine, and memantine help some people with dementia become less forgetful and confused. But the effects are small.

  • Rivastigmine seems to have more side effects than donepezil or galantamine.

  • A drug called carbamazepine can help reduce symptoms like getting agitated, acting aggressively, wandering, and having hallucinations.

  • Some older, smaller studies found that Ginkgo biloba, a Chinese herbal remedy, might help with forgetfulness and confusion. But more recent studies found no benefit. So, overall, there is no good reason to think Ginkgo biloba works.

  • Most drugs only slow down how quickly dementia progresses. They cannot stop dementia eventually getting worse.

The National Institute for Health and Clinical Excellence (NICE), the body that decides which treatments should be available on the NHS, has published guidance for doctors on the care and treatment of people with dementia (you can read about the guidance here: http://guidance.nice.org.uk/CG42/PublicInfo/pdf/English).[33]

How is Alzheimer's disease treated?

The National Institute for Health and Clinical Excellence (NICE), the government body that advises doctors about which treatments should be available on the NHS, has published guidance for doctors on certain drugs used to treat Alzheimer's disease.[34]

For people with mild to moderate Alzheimer's, NICE recommends the drugs donepezil, galantamine, and rivastigmine. It also provides the following guidance.

  • The drug treatment should be started by a specialist doctor, but may be continued by the patient's GP.

  • People taking these drugs should be checked regularly, usually by a specialist, to make sure the drug is helping.

  • Doctors should find out the carer's view of the patient's condition at the start of treatment and at check-ups.

The check-ups will probably include a test called the Mini-Mental State Examination (MMSE). Doctors should also look at how the patient behaves and how well he or she copes with daily life. In some cases, the Mini-Mental State Examination may not be helpful: for example, if the person has hearing difficulties or finds speaking difficult because of a stroke. Doctors are advised to use other methods to judge how severe the person's disease is in those cases.[34]

For people with severe Alzheimer's, NICE recommends the drug memantine. Memantine can also be taken by people with moderate Alzheimer's if they are unable to take one of the other drugs.

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Last Updated: August 15, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
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