Alzheimer's disease (AD) has no cure as of 2010, but the progression of memory impairment can be delayed with the proper use of medication. The prevalence of AD increases with age. Treatment that uses medications to delay memory loss, hopefully until a natural death occurs, is called "prevention through delay." Medications also can help treat the anxiety, mood disorders and depression that often accompany such devastating mental deterioration.
Medications to Prevent Memory Impairment
The U.s. Food and Drug Administration has approved four medications to slow down memory loss in people with mild to moderate AD. The drugs--donepezil (marketed under the brand name Aricept), reminyl (Galantamine), exelon (Rivastigmine tartrate) and cognex (Tacrine)--all act by stopping or slowing down the action of the enzyme acetylcholinesterase, which normally breaks down acetylcholine, a neurotransmitter. Acetylcholine is important for learning and memory. Memantine (Namenda) is the only medication used to treat patients with moderate to severe AD. It is thought to work by blocking the action of glutamate, an amino acid used as a seasoning. The drug nicotine--famous for making cigarette smoking addictive--is a stimulant that increases neurotransmitter release, and the drug reminyl activates nicotine receptors to improve short-term memory.
Medications to Reduce Anxiety and Mood Disorders
As AD progresses and leads to progressive confusion, inability to perform daily activities or communicate, and episodes of getting lost, anxiety and mood disturbances often occur. As the brain cells are destroyed, the person can have physical or verbal outbursts and often will pace, yell, hallucinate and have delusions. Anti-anxiety drugs such as as lorazepam (Ativan) or olanzapine (Zyprexa) might be prescribed to control behavioral outbursts or agitation, or a mood stabilizer such as divalproex sodium (Depakote) might be recommended. Anti-psychotic medications used to treat hallucinations, delusions and aggression include aripiprazole (Abilify), clozapine (Clozaril), haloperidol (Haldol), quetiapine (Seroquel), risperidone (Risperdal) and ziprasidone (Geodon). Sometimes a medication such as carbamazepine (Tegrital), typically used for seizure disorders, is used to treat aggression.
Anti-Depressants
Confusion is common to depression and AD alike, and many people with AD develop depression. When a doctor tries to make a diagnosis, he will try to rule out other causes of confusion and prescribe an anti-depressant drug to see if that alleviates the symptoms. Medications commonly prescribed to treat depression include: citalopram (Celexa), fluoxetine (Prozac), paroxeine (Paxil), sertraline (Zoloft) and trazodone (Desyrel).
Medications for Sleep Disorders
Sleep disorders are common among individuals with AD. They often lack exercise and mental stimulation during the day and might get confused about whether it is day or night. There are many medications used to promote sleep, including antidepressants and traditional sleeping pills such as Ativan. In addition, the medication Aricept, which is used to slow down memory loss, can decrease sleep disturbances such as sleep apnea.
References
- "Preventing Alzheimer's"; William Rodman Shankle, M.D,. & Daniel G. Amen, M.D.; 2004
- "The Forgetting", David Shenk, 2001
- "The Source for Alzheimer's and Dementia"; Pam Britton Reese; 2000
- "What If It's Not Alzheimer's?", Lisa Radin & Gary Radin, 2003
- "Alzheimer's Disease: Unraveling the Mystery"; National Institute on Aging/National Institute of Health; 2002
