Alzheimer’s Medication and Side Effects

7 min read

There is no medication that cures Alzheimer’s disease.

There are, however, drug treatments designed to manage Alzheimer’s symptoms. These drugs do not stop the underlying progression of the disease.

Drug treatments can affect Alzheimer's symptoms in three ways:

Improving symptoms
Worsening symptoms
No change in symptoms

which-alzheimers-medication-is-right-for-you

Alzheimer’s Drug Treatment Benefits

The benefits from drug treatments for Alzheimer’s symptoms are temporary and modest. Clinical trial results show less than 30% improvement in best case scenarios. People can interpret drug-induced benefits as proof of a remission or cure. While drugs can temporarily mask symptoms for some people, no drug treatments cure Alzheimer’s disease. Some drug-induced benefits disappear after the drug is stopped; some stop working over time. When drug-induced benefits eventually end, the true and current progression of Alzheimer’s disease is visible.

Alzheimer’s Drug Treatment Side Effects

In addition to modest and temporary benefits, Alzheimer’s drug treatments include side effects. These side effects can be mild, moderate or severe; they can be temporary or on-going. Some side effects from Alzheimer’s drug treatments can create new health problems, and/or worsen existing medical conditions. Monitoring symptoms at home is crucial, as is sharing this information with any doctors overseeing someone's Alzheimer’s care.

Alzheimer’s Drug Treatments

Cholinesterase Inhibitors (1996 to 2001)

In 1996 and the following 15 years, Alzheimer’s drug treatments focused on increasing communication between brain cells by increasing the amount of acetylcholine in the brain. Acetylcholine is a neurotransmitter and neuromodulator.

From 2007 to 2023, drug manufacturers made alternate forms of existing cholinesterase inhibitors (patches and liquids). Cholinesterase Inhibitors do not stop the progression of Alzheimer's. No new cholinesterase inhibitors have been approved by the FDA since 2001.

Examples: Donepezil (Aricept), Rivastigmine (Exelon), Galantamine (Razadyne).
Alzheimer's Stage: all stages
Pros: These medications may temporarily improve symptoms related to memory, thinking, and reasoning for some people.
Cons: They do not stop the progression of Alzheimer's and can have side effects like headache, nausea, constipation, diarrhea, vomiting, fatigue, insomnia, muscle cramps, and decreased appetite.

Drug Name	Brand Name	Approved
Donepezil	Aricept	1996
Rivastigmine	Exelon	2000
Galantamine	Razadyne	2001
Rivastigmine (patch)	Exelon Patch	2007
Donepezil (Oral Solution)	Aricept Liquid	2019
Donepezil (patch)	Adlarity	2023

Cholinesterase inhibitors like donepezil, galantamine, and rivastigamine may show noticeable improvement or stabilization in symptoms over a period of several months.It is usual to start on a low dose and gradually increase it. A trial period of 3 to 4 months is often used to assess whether the medication is helping. If no improvement or stabilization is observed within this timeframe, it may be reasonable to consider stopping the medication.

Aricept® Prescription Information
Exelon® Prescription Information
Razadyne® Prescription Information

NMDA Receptor Antagonists (2003)

In 2003, the FDA approved an Alzheimer’s drug treatment focused on regulating a neurotransmitter involved in memory and learning: glutamate. NMDA receptor antagonists do not stop the progression of Alzheimer's. No new NMDA receptor antagonists for Alzheimer’s disease have been approved by the FDA since2003.

Examples: Memantine (Namenda)
Alzheimer's Stage: moderate to severe Alzheimer's
Pros: This medication may modestly improve memory, cognition and behavior for some people.
Cons: It does not stop the progression of Alzheimer's and can have side effects like headache, dizziness, constipation, diarrhea, sleepiness, confusion, and back pain.

Drug Name	Brand Name	Approved
Memantine	Namenda	2003

Namenda® Prescription Information

alzheimers-patients-undergoing-monoclonal-antibody-treatment

Monoclonal Antibodies (MABs) (2021 to Present)

Monoclonal antibodies (MABs) for Alzheimer’s disease are the first new drug treatment approved by the FDA since 2003. These drug treatments are designed to target and remove amyloid-β (Aβ) plaques, a key pathological feature of the Alzheimer’s disease, thereby slowing cognitive decline. Monoclonal antibodies (MABs) do not stop the progression of Alzheimer's disease.

Examples: Lecanemab (Leqembi), Donanemab (Kisunla)
Alzheimer’s Stage: MCI (mild cognitive impairment), early/mild Alzheimer’s
Pros: Targets amyloid plaques, potentially slowing cognitive decline, and may improve cognitive function. Clinical trials have shown moderate benefits in early-stage patients.
Cons: Administered via IV infusion every 2 – 4 weeks. Monoclonal antibodies (MABs) for Alzheimer’s disease do not stop the progression of Alzheimer's. These drugs can have side effects like headache, confusion that gets worse, dizziness, vision changes, nausea, difficulty walking, seizures, difficulty speaking and infusion site reactions. Allergic reactions can include swelling of the face, lips, mouth, or eyelids, difficulty breathing, and hives. Risks include brain swelling and bleeding.

Drug Name	Brand Name	Approved
Lecanemab	Leqembi	2023
Donanemab	Kisunla	2024

Deciding for or against drug treatments for Alzheimer’s disease is a difficult decision. Drug treatment benefits are temporary and modest, while the side effects can severely impact someone's life on a daily basis. It’s up to each person to weigh the personal cost and possible benefits of Alzheimer's medications. Ultimately, no drug treatment stops the progression of Alzheimer’s disease.