While there are no treatments specifically for PCA, medicines that are given to people with Alzheimer’s disease may help.

There are three cholinesterase inhibitors available to treat Alzheimer’s:

  • donepezil (Aricept)
  • rivastigmine (Exelon)
  • galantamine (Reminyl)

All of these drugs work in a similar way. So far, research has not found a difference in how effective each drug is, but some people may respond better to one drug than another or have fewer side-effects.

Cholinesterase inhibitors might be given to people with mild to moderate PCA, and doctors will continue to prescribe one of these drugs as symptoms progress, so long as it is safe and suitable to do so.

How cholinesterase inhibitors work

In PCA and Alzheimer’s disease, nerve cells become damaged and lose their ability to communicate. Cholinesterase inhibitors work by increasing the amount of a chemical called acetylcholine, that helps messages to travel around the brain. These messages are vital to the way we move, think and remember. Cholinesterase inhibitors can reduce the symptoms of Alzheimer’s for a time.

These treatments 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.

Effects of cholinesterase inhibitors

People with PCA may find that their symptoms improve by taking a cholinesterase inhibitor. This could be improvement in thinking, memory, communication or with day-to-day activities. Others may find that their condition stays the same, or that their symptoms do not worsen as quickly as they would have expected. Some people may not notice any effect at all.

As these drugs don’t stop the disease from progressing in the brain, symptoms will continue to get worse over time. However, they can help some people to function slightly better than they would do without the drug.

The most common side-effects of cholinesterase inhibitors are feeling or being sick, diarrhoea, having trouble sleeping, muscle cramps and tiredness. These effects are often mild and usually only temporary. Not everyone will experience side-effects. If you are worried about side-effects you can talk about this with your doctor.

Memantine

Memantine (Ebixa or Axura) is recommended as an option for people with moderate or severe Alzheimer’s disease, and for people with moderate Alzheimer’s if cholinesterase inhibitors are not suitable. Memantine is normally given as a tablet, but it is also available as a liquid.  Your doctor will discuss the most suitable form for you. Like cholinesterase inhibitors, memantine is not a cure. However, it can help with some symptoms.

Physiotherapy or occupational therapy may help people with PCA to find ways to manage some of their symptoms. Some people with PCA may also benefit from visual aids and resources for people with sight problems. These may include audio books, devices with simple displays, voice recognition software and walking aids. People may choose to carry a symbol cane to let others know that they have sight problems. For more information contact the Royal National Institute of Blind People at www.shop.rnib.org.uk or call 0303 123 9999.

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Treatments for dementia

Read more about treatments for dementia, including information on treating depression, anxiety and agitation and for information on antipsychotics.

What is posterior cortical atrophy?

Find out more about the symptoms and causes of posterior cortical atrophy, and the treatments currently available.

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This information was written in April 2020 and is due for review in April 2022. Please contact us if you would like a version with references.

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