Prescription Medicines for Alzheimer's
The Different Types & How They Each Function
Article Summary
• There are several types of medications used to treat Alzheimer's disease. They differ in which symptoms they treat and at what stage of the disease the patient is at.
• Medications are unable to reverse the disease, but can slow it, which is why it's important to decide if medication is right for you as early as possible after symptoms are noticed.
While there are several different types and brand names of medications for Alzheimer's disease, they can generally be broken down into two categories:
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Acetylcholinesterase inhibitors and
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NMDAR antagonists.
We explain the benefits of each and how they function below.
Acetylcholinesterase Inhibitors
(Aricept, Galtamine, & Rivastigmine)
Acetylcholinesterase inhibitors function by protecting acetylcholine. Acetylcholine is a brain chemical that has a significant role in helping nerves communicate. Acetylcholine plays a significant role in memory, alertness, thought, and judgement.
Donepezil (Brand name Aricept), Galantamine (Brand name Radadyne), and Rivastigmine (Brand name Exelon) are three of the most popular drugs classified as Acetylcholinesterase Inhibitors. While the drugs in this category vary from one another, they all function in a similar fashion.
Evidence does not show a significant difference in effectiveness between one drug or another; however there has been some evidence for specific use cases for each drug. Below we compare several Acetylcholinesterase inhibitors.
Effectiveness
Studies have shown that the effectiveness of acetylcholinesterase inhibitors is modest. In a study of over 5,000 patients diagnosed with Alzheimer’s, individuals taking an acetylcholinesterase inhibitor for nine months improved by half a point on the mini-mental state examination, the score is out of a possible 30 points. They function to preserve the patient's current cognitive ability, rather than improve it.
NMDAR antagonists (Namenda)
NMDAR antagonists function by reducing the effects of a chemical in the brain, glutamate. Glutamate bonds to neurons in the brain and excessive glutamate is believed to damage these neurons. The goal of NMDAR antagonists is to reduce glutamate levels in the brain to healthy amounts.
Memantine (Brand name Namenda) is currently the only FDA approved drug in this class and is currently prescribed to treat moderate to severe Alzheimer’s, but not mild Alzheimer’s.
Effectiveness
There is an insufficient amount of studies conducted on memantine to determine its effectiveness, due to its relatively recent approval for Alzheimer’s treatment. While some studies have suggested a benefit to overall functioning of the individual, its effects on cognition are unclear. No side effect was reported more in memantine-treated individuals than in those taking a placebo.
Recommendation
Existing prescription drugs for Alzheimer’s leave something to be wanted. Neither class of medication cures Alzheimer’s disease nor fully halts its progression. Existing drugs serve to increase cognitive overall ability, but unfortunately they do not work for everyone and wear off in certain cases.
When considering taking, and when first taking, a prescription medication for Alzheimer’s it is important to pay attention to improvements, side effects, and long-term cost in order to decide if the medication is suitable for you.
