There is no cure for Alzheimer's disease. However, there are several drug treatments that may improve or stabilize symptoms and several care strategies and activities that may minimize or prevent behavioral problems. Researchers continue to look for new treatments to alter the course of the disease and other strategies to improve the quality of life for people with dementia.

Some of the prescription medications currently approved by the U.S. Food and Drug Administration (FDA) to treat cognitive Alzheimer symptoms are in a class of drugs called cholinesterase (KOH-lean-STE-raise) inhibitors. These drugs are designed to prevent the breakdown of acetylcholine (pronounced a-SEA-til-KOH- lean), a chemical messenger in the brain that is important for memory and other thinking skills. The drugs work to keep levels of the chemical messenger high, even while the cells that produce the messenger continue to become damaged or die. About half of the people who take cholinesterase inhibitors experience a modest improvement in cognitive symptoms.

Three cholinesterase inhibitors are commonly prescribed: donepezil (Aricept^®), approved in 1996; rivastigmine (Exelon^®), approved in 2000; and galantamine (Reminyl^®), approved in 2001. Tacrine (Cognex^®), the first drug in this class, was approved in 1993 but is NEVER prescribed today because of associated side effects, including possible liver damage.

For more information, see Cholineterase Inhibitors Fact Sheet.

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Memantine (Namenda^®) is a drug approved in October 2003 by the FDA for treatment of moderate to severe Alzheimer's disease.

Memantine is classified as an uncompetitive low-to-moderate affinity N-methyl-D-aspartate (NMDA) receptor antagonist, the first Alzheimer drug of this type approved in the United States. It appears to work by regulating the activity of glutamate, one of the brain's specialized messenger chemicals involved in information processing, storage and retrieval. Glutamate plays an essential role in learning and memory by triggering NMDA receptors to allow a controlled amount of calcium to flow into a nerve cell, creating the chemical environment required for information storage.

Excess glutamate, on the other hand, overstimulates NMDA receptors to allow too much calcium into nerve cells, leading to disruption and death of cells. Memantine may protect cells against excess glutamate by partially blocking NMDA receptors.

For more information, see the Memantine Fact Sheet

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The glutamate regular known as Memantine (Namenda®) is a drug approved in October 2003 by the FDA for treatment of moderate to severe Alzheimer's disease. Memantine is classified as an uncompetitive low-to-moderate affinity N-methyl-D-aspartate (NMDA) receptor antagonist, the first Alzheimer drug of this type approved in the United States. It appears to work by regulating the activity of glutamate, one of the brain's specialized messenger chemicals involved in information processing, storage and retrieval. Glutamate plays an essential role in learning and memory by triggering NMDA receptors to allow a controlled amount of calcium to flow into a nerve cell, creating the chemical environment required for information storage.

Excess glutamate, on the other hand, over stimulates NMDA receptors to allow too much calcium into nerve cells, leading to disruption and death of cells. Memantine may protect cells against excess glutamate by partially blocking NMDA receptors.

In a recent study, individuals taking memantine (Namenda) when combined with donepezil (Aricept) fared better on measures of cognition, daily activities, and overall function than individuals who took a placebo with their donepezil.

Results of this multicenter clinical trial are reported in the Jan. 21 2004 JAMA, the journal of the American Medical Association. Forest Laboratories, the pharmaceutical company that markets memantine in the United States, funded the study.

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Vitamin E supplements are often prescribed as a treatment for Alzheimer's disease because they may help brain cells defend themselves from “attacks.” Normal cell functions create a byproduct called a free radical, a kind of oxygen molecule that can damage cell structures and genetic material. This damage, called oxidative stress, may play a role in Alzheimer's disease. Cells have natural defenses against this damage, including the antioxidants vitamins C and E, but with age some of these natural defenses decline. Research has shown that taking vitamin E supplements may offer some benefit to people with Alzheimer's.

Most people can take vitamin E without side effects. However, any change in medications should first be discussed with a primary care physician because all medication can cause side effects or interactions with other medications. A person taking “blood-thinners,” for example, may not be able to take Vitamin E or will need to be monitored closely by a physician.

For more information, see Vitamin E Fact Sheet.

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