The Dementias: Hope Through Research
Some dementias are treatable. However, therapies to stop or slow common neurodegenerative diseases such as AD have largely been unsuccessful, though some drugs are available to manage certain symptoms.
Most drugs for dementia are used to treat symptoms in AD. One class of drugs, called cholinesterase inhibitors, includes donepezil, rivastigmine, and galantamine. These drugs can temporarily improve or stabilize memory and thinking skills in some people by increasing the activity of the cholinergic brain network. The drug memantine is in another class of medications called NMDA receptor agonists, which prevents declines in learning and memory. NMDA receptor agonists work by regulating the activity of the neurotransmitter glutamate. When glutamate activity levels are excessive, neurons may die. Memantine may be combined with a cholinesterase inhibitor for added benefits. These drugs are sometimes used to treat other dementias as well. None of these drugs can stop or reverse the course of the disease.
- Creutzfeldt-Jakob disease. There are no treatments to cure or control CJD. Management focuses on reducing symptoms and making people comfortable.
- Dementia with Lewy bodies. Drugs available for managing DLB are aimed at relieving symptoms such as stiffness, hallucinations, and delusions. However, many of the agents for treating the physical symptoms, particularly antipsychotics, can make the mental health symptoms worse. Conversely, drugs used to treat mental health symptoms can exacerbate physical symptoms. Studies suggest that AD drugs may benefit people with DLB.
- Frontotemporal disorders. There are no medications approved to treat or prevent FTD and most other types of progressive dementia. Sedatives, antidepressants, and other drugs used to treat Parkinson’s and Alzheimer’s symptoms may help manage certain symptoms and behavioral problems associated with the disorders.
- Parkinson’s disease dementia. Some studies suggest that the cholinesterase inhibitors used in people with AD might improve cognitive, behavioral, and psychotic symptoms in people with Parkinson’s disease dementia. The U.S. Food and Drug Administration has approved one Alzheimer’s drug, rivastigmine, to treat cognitive symptoms in PDD.
- Vascular dementia. This type of dementia is often managed with drugs to prevent strokes. The aim is to reduce the risk of additional brain damage. Some studies suggest that drugs that improve memory in AD might benefit people with early vascular dementia. Most of the modifiable risk factors that influence development of vascular dementia and VCI are the same risk factors for cerebrovascular disease, such as hypertension, atrial fibrillation, diabetes, and high cholesterol. Interventions that address these risk factors may be incorporated into the management of vascular dementia.
Publication Date: September 2013
Page Last Updated: December 9, 2013