When an underlying nutrient deficiency, hormonal disorder or side effect of drugs causes temporary dementia, the condition can be reversed with the help of proper treatment. However, when dementia is caused by brain damage from stroke or other brain disorder, the primary object of treatment is to arrest the progression of the ailment and prevent further memory loss. Medications are also needed to treat various behavioral symptoms of dementia.
Medications to Treat Dementia
Researches have revealed that people suffering from dementia have insufficient amount of the neurotransmitter acetylcholine in the brain. Acetylcholine aids communication between nerve cells essential for maintaining the normal functioning of the brain. Cholinesterase inhibitors work by suppressing the activities of the cholinesterase enzyme that break down acetylcholine. Increase in the acetylcholine level in the brain attenuates dementia. Although primarily used for treating Alzheimer’s disease, cholinesterase inhibitors are also widely used for treating vascular dementia caused by stroke and other types of dementias. Cholinesterase inhibitors currently available for treating dementia include donepezil, rivastigmine and galantamine.
Cholinesterase inhibitors cannot reverse memory loss. They can only help to slow down progression of dementia. The effect of these drugs varies from person to person. They are usually effective in people suffering from mild to moderate symptoms of Alzheimer’s disease. By stopping the drug, you will lose all its positive effect on your mental function within 4 to 6 weeks. Diarrhea, nausea, vomiting and weight loss are common side effects of these drugs.
Memantine is one of the earliest drugs developed for treating Alzheimer’s diseases. It is also effective in treating mild to moderate symptoms of vascular dementia. Memantine can neither cure nor arrest the progression of dementia. It only causes moderate improvement in mental function. It is classified as a NMDA antagonist. By binding to the NMDA receptor, it lowers the level of the neurotransmitter glutamate in the brain. While normal glutamate level is essential for maintaining memory and cognitive skills, too much glutamate kills the nerve cells, resulting in memory loss. People on memantine should limit consumption of vegetables, peas, beans and citrus fruits. Fatigue, vomiting, constipation, headache, dizziness, drowsiness, confusion, coughing and back pain are common side effects of the drug.
Hallucination, disordered thought and delusion are common problems in dementia patients. They are treated with antipsychotic medications. The new atypical antipsychotic drugs used for treating mood disorders have fewer side effects than the older antipsychotic medications.
Drugs commonly used for treating behavioral problems of dementia patients include clozapine, olanzapien, risperidone, ziprasidone and quetiapine. Dizziness, drowsiness and rapid heartbeat are common side effects of these drugs.
Among the different types of antidepressants, selective serotonin reuptake inhibitors (SSRIs) are most effective in treating depression in people suffering from dementia. By increasing the serotonin level in the brain, these drugs help to improve mood. SSRIs used for treatment include citalopram, fluoxetine, sertraline, escitalopram and paroxetine. Nausea, diarrhea, drowsiness, dry mouth, nervousness, headache, poor sex drive, weight gain, insomnia and skin rash are common side effects of these drugs.
While cholinesterase inhibitors and memantine target the brain chemicals associated with memory loss, behavioral symptoms of dementia such as depression, agitation, sleeping problems and hallucinations are treated with antipsychotic medications and antidepressants.
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