Alzheimer’s or Dementia Medications

What drugs are approved for Alzheimer's disease?
see link above for a NIH fact sheet.

Five drugs have been approved by the U.S. Food and Drug Administration (FDA) for treating the cognitive symptoms of Alzheimer's disease. (See box.) Reminyl, Exelon, Aricept and Cognex belong to a class of drugs known as cholinesterase inhibitors. Each acts in a different way to delay the breakdown of acetylcholine, a chemical in the brain that facilitates communication among nerve cells and is important for memory. Alzheimer's disease is associated with inadequate levels of this important neurotransmitter. Namenda acts by a different mechanism. It shields brain cells from overexposure to another neurotransmitter called glutamate, excess levels of which contribute to the death of brain cells in people with Alzheimer's.

DRUGS APPROVED FOR ALZHEIMER'S

Brand Name	Generic Name	When Approved	More Information
Namenda®	memantine	2003	Fact sheet
Razadyne, Reminyl®	galantamine	2001	Fact sheet
Exelon®	rivastigmine	2000	Fact sheet
Aricept®	donepezil	1996	Fact sheet
*Cognex®	tacrine	1993	Fact sheet

* Cognex is rarely prescribed due to serious side effects, including possible liver damage.

In general, Reminyl, Exelon and Aricept are most effective when treatment is begun in the early stages. Namenda is the only drug shown to be effective for the later stages of the disease. They have all been shown to modestly slow the progression of cognitive symptoms and reduce problematic behaviors in some people, but at least half of the people who take these drugs do not respond to them. While the overall "treatment effect" of these medications is modest, studies show that when they do work, they can make a significant difference in a person's quality of life and day-to-day functioning ("activities of daily living"). The drugs have different side effects. Some are taken once a day (Aricept), others twice a day (Exelon, Reminyl and Namenda).