By Mike Glenn, R.Ph., CGP
Alzheimer’s is a neurodegenerative disease characterized by loss of function and death of nerve cells leading to progressive memory loss and cognitive decline. It affects more than 5 million Americans and accounts for most cases of Dementia. About one-half of people over 85 are affected. Healthcare workers with assisted living and long-term care facilities are very familiar with the symptoms of Alzheimer’s.
Currently, there are no medications that can stop or reverse the symptoms of Alzheimer’s disease. But there are medications that can ease some of the symptoms and slow progression in some people. Unfortunately, they do not work for everyone but are worth considering in attempting to slow progression. These medications work best for those with early to middle stages of Alzheimer’s. There are 2 classes of medications that are commonly used alone or in combination.
Acetylcholinesterase inhibitors are medications that slow the breakdown of a chemical in the brain called acetylcholine, which is important with learning and memory. They attempt to compensate for the death of certain neurons. Symptoms are slowed in about half of the people who take them. Medications include Aricept, Razadyne, and Exelon. Aricept is the most commonly used and is thought to have the fewest side effects. Side effects for this class are usually mild but include diarrhea, nausea, vomiting, insomnia, and weight loss.
Namenda is an NMDAR antagonist. This medication prevents the overproduction of glutamate. Overproduction of Glutamate can lead to neurodegeneration and cell damage. Side effects are mild but include dizziness, confusion, and headache. The use of Namenda is often used in combination with an acetylcholinesterase inhibitor with success. Namzaric is a medication that is a mixture of Aricept and Namenda.
Prescribers usually start with low doses and gradually increase based on how the patient tolerates the drugs. Other medications may be used to decrease the symptoms of this. Sleep aids and antianxiety meds are often used. Anticonvulsants may help with aggression associated with Alzheimer’s. Antipsychotics can help with behaviors, paranoia, agitation, and hallucinations.
Scientists have made remarkable progress in understanding how Alzheimer’s disease affects the brain. Research has developed to a point where we can look beyond treating symptoms and address the underlying disease process. Until new treatments are available, we can only hope that existing medications can slow the progress of this unfortunate disease.