Dementia Treatment Options: Medications & Risks

IS THERE A CURE FOR DEMENTIA?

There is currently no cure for most forms of dementia, including Alzheimer’s disease.

However, treatment has advanced significantly — especially in the last few years.

Today, treatment falls into three main categories:

• Symptom management (memory, behavior, mood)
• Disease-modifying therapies (newer drugs that slow progression)
• Environmental and caregiving interventions

The goal is not just to extend life — but to preserve function, dignity, and quality of life.

---

STANDARD MEDICATIONS (WHAT MOST PEOPLE ARE PRESCRIBED)

1. Cholinesterase Inhibitors

Examples: Donepezil (Aricept), Rivastigmine (Exelon), Galantamine

How they work: These medications increase acetylcholine, a neurotransmitter involved in memory and learning.

What they help with:

• Short-term memory
• Attention
• Basic communication

Who they are for: Early to moderate Alzheimer’s (sometimes other dementias)

Common side effects:

• Nausea
• Loss of appetite
• Diarrhea
• Sleep disturbances

Important reality: These drugs do not stop the disease — they may temporarily stabilize symptoms.

---

2. Memantine (Namenda)

How it works: Regulates glutamate, which affects learning and memory pathways.

Used for: Moderate to severe Alzheimer’s

Benefits:

• May improve daily functioning
• Can reduce confusion

Side effects:

• Dizziness
• Headache
• Constipation
• Confusion (in some cases)

Often used in combination with cholinesterase inhibitors.

Learn more: Alzheimer’s Association Medication Guide

---

NEW ALZHEIMER’S DRUGS (DISEASE-MODIFYING THERAPIES)

These are the biggest recent breakthrough in dementia treatment.

Unlike older drugs, these aim to slow disease progression by targeting amyloid plaques.

---

Leqembi (Lecanemab)

What it does: Removes amyloid plaques from the brain.

Who it’s for:

• Mild cognitive impairment (MCI) due to Alzheimer’s
• Early-stage Alzheimer’s

How it’s given:

• IV infusion every 2 weeks

Benefits:

• Slows cognitive decline (not reverses)

Risks (important):

• ARIA (brain swelling or bleeding seen on MRI)
• Headaches
• Infusion reactions

Monitoring required:

• Regular MRI scans

Learn more: FDA Leqembi Approval Details

---

Kisunla (Donanemab)

What makes it unique:

• Treatment may stop once plaques are reduced

Who it’s for:

• Early Alzheimer’s patients with confirmed amyloid

Risks:

• Similar ARIA risks
• Infusion-related side effects

Learn more: Donanemab Overview

---

WHO QUALIFIES FOR THESE NEW DRUGS?

Not everyone with dementia is eligible.

Typical requirements:

• Early-stage Alzheimer’s diagnosis
• Confirmed amyloid (via PET scan or spinal fluid test)
• No significant brain bleeding risk
• Able to undergo regular MRIs

Important: These drugs are not typically used in later stages.

---

HOW TO GET ACCESS TO THESE TREATMENTS

Access is one of the biggest barriers.

Steps:

1. See a neurologist or memory specialist
2. Get cognitive testing and diagnosis
3. Confirm amyloid presence
4. Discuss eligibility and risks
5. Check insurance coverage (Medicare may cover with conditions)

Specialized centers often offer these treatments.

Find resources:  Find a neurologist near you

---

MANAGING BEHAVIORAL & EMOTIONAL SYMPTOMS

Many of the hardest symptoms are behavioral, not cognitive.

Medications may include:

• Antidepressants
• Anti-anxiety medications
• Sleep aids
• Antipsychotics (used cautiously)

Important warning: Some medications increase fall risk or confusion.

---

NON-DRUG THERAPIES (ESSENTIAL)

These often have the biggest day-to-day impact.

• Routine and structure
• Music therapy
• Physical movement
• Calm environments
• Memory-friendly design

These approaches reduce agitation and improve emotional stability.

---

CAREGIVER STRATEGIES (HIGH IMPACT)

The way care is delivered directly affects symptoms.

• Use short, clear communication
• Avoid correcting or arguing
• Focus on emotional validation
• Maintain dignity during care tasks

Reality: The right caregiving approach can dramatically reduce distress.

---

WHAT’S COMING NEXT IN TREATMENT

• Tau-targeting drugs
• Anti-inflammatory treatments
• Gene therapies
• Earlier detection tools

The field is moving toward earlier and more personalized care.

---

FREQUENTLY ASKED QUESTIONS

Do the new Alzheimer’s drugs cure dementia?

No — they slow progression but do not cure the disease.

Who qualifies for Leqembi?

People in early-stage Alzheimer’s with confirmed amyloid.

Are there risks?

Yes — including brain swelling (ARIA), which requires monitoring.

Are these treatments covered by insurance?

Coverage is evolving, but Medicare may cover under certain conditions.

What helps the most overall?

A combination of medication, environment, and caregiving approach.

Back to the Section List