The treatments currently available in the UK for Alzheimer’s do not slow or stop the disease from getting worse, but they may help manage the symptoms for a time. It’s important to discuss your treatment options with the people involved in your care.
If you are prescribed a drug for Alzheimer’s disease, treatment is usually started by your own doctor following guidance from a specialist doctor after you have been to a memory clinic. Alternatively, your own doctor may start your treatment and it may be continued and monitored either by a specialist or by your doctor.
Doctors often refer to people as having mild, moderate or severe Alzheimer’s disease. This reflects how much the symptoms affect the person’s day to day life. Different drug treatments are recommended at different stages of the disease.
People with mild to moderate Alzheimer’s disease could benefit from taking a drug called a cholinesterase inhibitor. These increase the amount of a chemical called acetylcholine that helps messages to travel around the brain. Cholinesterase inhibitors do not prevent the disease from getting worse but may help people to function better every day than they would do without the drug.
There are three cholinesterase inhibitors to treat Alzheimer’s:
- donepezil (Aricept)
- rivastigmine (Exelon)
- galantamine (Reminyl).
These are given to people with mild or moderate Alzheimer’s, and doctors will continue to prescribe one of these drugs as symptoms progress, so long as it is safe and suitable to do so.
Some people with Alzheimer’s find their condition improves by taking a cholinesterase inhibitor. They may see an improvement in thinking, memory, communication, or day-to-day activities. Others may not notice an effect.
The drugs may have side-effects in some people. The most common are feeling or being sick, being unable to sleep, having diarrhoea, muscle cramps or tiredness. These effects are often mild and usually don’t last long. Most people do not get these side effects.
Memantine (Ebixa or Axura) is recommended for people with moderate or severe Alzheimer’s disease, and for people with moderate Alzheimer’s if cholinesterase inhibitors don’t help or are not suitable. Memantine also helps nerve cells in the brain communicate with each other. It does this by regulating a chemical called glutamate in the brain. In Alzheimer’s disease this can allow brain cells to work better for longer, and it can help to reduce the symptoms of Alzheimer’s disease for a while.
Like cholinesterase inhibitors, memantine is not a cure or does not slow down the progression of the disease. However, it can help with some symptoms. Some people taking memantine may not notice any effect at all. Others may find that their condition stays the same when they would have expected it to decline.
People may experience side-effects when taking memantine. The most common side-effects are headaches, dizziness, drowsiness, and constipation. These are usually short-term effects.
Cholinesterase inhibitors and memantine are normally given as tablets or capsules, but they are available in a liquid form too. Donepezil is also available as a tablet that dissolves on the tongue, and Rivastigmine is available in patches, where the drug is absorbed through the skin.
Your doctor will discuss the most suitable form for you. People with moderate or severe Alzheimer’s disease are sometimes offered combination therapy, where a cholinesterase inhibitor and memantine are given together.
There are non-drug treatments available to manage symptoms of Alzheimer's disease. You can find out more in our booklet, treatments for dementia, and discuss your options with your doctor or care provider.
Have you or a loved one recently been diagnosed with Alzheimer's disease?
Treatments for dementia
Read more about treatments for dementia, including information on treating depression, anxiety and agitation and for information on antipsychotics.
What is Alzheimer's disease?
Find out more about the symptoms and causes of Alzheimer's disease, and the treatments currently available.
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