Treatment Options

What medications are available?

Your doctor may prescribe some medications for your loved one that are known to benefit patients with Alzheimer’s disease.

There are four medications available to treat patients with Alzheimer’s disease:

Namenda® (also called memantine)

Razadyne® (also called galantamine, previously named Reminyl®)

Exelon® (also called rivastigmine)®

Aricept® (also called donepezil)

An older medication called Cognex® (tacrine) is still available though rarely used since the newer medications listed above became available in more recent years.  Cognex works similarly to Razadyne, Exelon and Aricept in that it is a cholinesterase inhibitor, but has been associated with serious liver problems and requires dosing four times a day.

How do I know which one is best for my loved one?

The effects of medications vary from patient to patient.  Your doctor will help decide which one is best for your loved one based on their stage of the disease, ability to tolerate the medication, and the benefits they get from it over the long term.

For example, Namenda is usually reserved for patients with more moderate to severe Alzheimer’s disease.  Razadyne, Exelon, and Aricept are generally prescribed first, in the earlier stages of the disease.

How do these medications work?

Namenda works by blocking the negative effects of an important chemical in the brain, called glutamtate.  In the later stages of Alzheimer’s disease, too much glutamate can damage areas of the brain important for learning and memory. 

Razadyne, Exelon and Aricept belong to a group of medications called cholinesterase inhibitors.  They work by blocking an enzyme in the brain, cholinesterase, from breaking down acetylcholine.  Acetylcholine is an important chemical in the brain known to help with learning and memory.  Patients with Alzheimer’s disease have too little acetylcholine in their brain, so these medications make it possible to have more acetylcholine left, therefore improving their brain functioning.

What does the research say about these medications?

There are quite a few studies done on all of these medications in the various stages of Alzheimer’s disease and other types of dementia. In a nutshell, their benefits are summarized below:

Namenda:  studies have shown its proven efficacy in patients with moderate to severe stages of Alzheimer’s disease in the areas of cognition and function and behavior.  Additionally, studies done in combination with Aricept shows those patients taking both Aricept and Namenda did better than those taking Aricept alone.

Aricept, Exelon and Razadyne:  studies have shown that all these medications are effective in maintaining mild to moderate Alzheimer’s disease patients’ cognitive, functional, and behavioral abilities during the time they were given. Long-term studies for up to four years are also available for some of these medications and show that as long as the drug is given most patient’s abilities are maintained. Some patients deteriorate despite the medications and some have shown marked improvement.