Treatments
At present the mainstay of Alzheimer's treatment is medication, both to slow symptom progression and to manage the behavioral and psychiatric symptoms of AD.Medications to slow symptom progression
The medications most commonly given to delay the progression of symptoms in Alzheimer's are a group of drugs called cholinesterase inhibitors. These drugs were approved by the FDA over a decade ago. They work by slowing down the body's destruction of the neurotransmitter acetylcholine.The cholinesterase inhibitors include:
- Tacrine (Cognex). This drug is the oldest cholinesterase inhibitor in use. It is used less often than newer agents because it must be taken four times a day and may cause liver damage.
- Donepezil (Aricept). This drug is the one used most commonly as of 2002 to treat AD. It has fewer side effects than tacrine and can be given in one daily dose.
- Rivastigmine (Exelon). This drug is taken twice daily.
- Galantamine (Reminyl). This is the newest cholinesterase inhibitor, approved in late 2001. It acts on an additional acetylcholine receptor.
Medications for BPSD
Medications are also prescribed to manage the behavioral and psychiatric symptoms of AD, which are often quite stressful for caregivers if the patient is being cared for at home. These medications are usually prescribed for specific symptoms:- Delusions: Antipsychotic drugs, usually haloperidol (Haldol) or risperidone (Risperdal).
- Agitation: Short-term anti-anxiety drugs, usually lorazepam (Ativan) or buspirone (BuSpar).
- Depression: One of the selective serotonin reuptake inhibitors (SSRIs), at half the dosage for a young adult.
- Pain: Acetaminophen or a very low dose of codeine.
Alternative and complementary treatments
Some complementary therapies have been shown to benefit patients with Alzheimer's.NATUROPATHY. A naturopathic approach to Alzheimer's includes supplementing antioxidant vitamins (vitamins A, E, and C) in the patient's diet, along with adding carotenoids, small amounts of selenium and zinc, and thiamin. Botanical supplements that have been said to improve cognitive function include Huperzine A, a Chinese tea, and an extract made from Gingko biloba , a tree that is native to China and is said to be the world's oldest living deciduous tree. GBE, or gingko biloba extract, is the most frequently used herbal medicine in Europe. It is available in Germany by prescription and in an over-the-counter form; and has been approved by the German Commission E for dementia-related memory loss. Gingko extract is thought to work in a manner similar to the cholinesterase inhibitors. At present the National Center for Complementary and Alternative Medicine (NCCAM) is conducting studies of gingko extract as a treatment for Alzheimer's.
MUSIC THERAPY. Music therapy has been found to calm agitated patients with Alzheimer's, to improve mood, and to enhance their long-term memory. Old familiar songs are particularly effective in improving recall. In other studies, music therapy has been shown to reduce sensations of chronic pain in patients with AD.
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