Reviewed by the Help Dementia Editorial Team — our editors review every article for accuracy against guidance from the National Institute on Aging, the Alzheimer’s Association, and peer-reviewed sources.
Dementia medications fall into a few clear groups: cholinesterase inhibitors, NMDA modulators, and the newer anti-amyloid antibodies. None cure dementia. The right one slows symptoms or buys function. Here is how they compare.
Understanding dementia medications helps families ask better questions and make calmer decisions. The detail below covers what doctors usually skip when explaining dementia medications.
Cholinesterase Inhibitors
Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). All work by raising acetylcholine in the brain. Used for mild to moderate Alzheimer’s. Modest benefit on cognition for 6 to 12 months.
NMDA Modulator: Memantine
Memantine (Namenda) protects neurons from glutamate overstimulation. Used in moderate to severe Alzheimer’s, often added to a cholinesterase inhibitor.
Anti-Amyloid Antibodies
Lecanemab (Leqembi) and donanemab (Kisunla) clear amyloid plaque from the brain. Modest slowing of decline in early Alzheimer’s. Significant infusion-related risks including brain swelling and bleeding.
Off-Label Options
Some clinicians use medications like trazodone for sleep, citalopram for agitation, and prazosin for nightmares. Not dementia-specific but helpful for symptoms.
What Does Not Work
Coconut oil, ginkgo biloba in high quality trials, and many supplement combinations marketed for memory have failed to show benefit.
Frequently Asked Questions
Which dementia medication has the fewest side effects?
Donepezil at 5mg is generally best tolerated. Rivastigmine patch causes less GI upset than oral forms.
Are dementia medications worth it?
For the right patient, modest cognitive benefit and family quality-of-life improvement is meaningful even without cure.
For more, see Alzheimer’s Association.
Related Guides in This Cluster
- Donepezil Side Effects Elderly Warning Signs
- Aricept Vs Exelon Mild Alzheimers
- Memantine Namenda When Doctors Add
- Galantamine Side Effects Families Miss
- Donepezil Dosage 5Mg 10Mg 23Mg Differences
- Stopping Donepezil Suddenly
- Leqembi Vs Donepezil Honest Comparison
- Donepezil Sleep Nightmares
- Cholinesterase Inhibitors Plain English
