Alzheimers: Drugs For Behavioral Conditions

Detailed information on medications used to relieve behavioral symptoms in Alzheimer's and dementia patients.

Alzheimer's and Dementia: drugs used to relieve behavioral symptoms

People with Alzheimer's and dementia may, at some point in their illness, develop symptoms such as depression, restlessness, aggressive behavior and psychosis (delusions and hallucinations). While it is important to try to understand and address the underlying reasons for these problems, it may be necessary at times to prescribe medication if the symptoms are distressing, persistent and have not responded to psychological treatments. This information sheet describes the different types of drugs that may be prescribed.

Avoid drugs unless they are really necessary

Before any of the drugs mentioned in this information sheet are prescribed it is essential to ensure that the person with dementia is physically healthy, comfortable and well cared for.

Whenever possible, the person should be helped to lead an active life, with interesting and stimulating daily activities. By minimizing distress and agitation it is usually possible to avoid the use of sedative drugs altogether.

If, after trying non-drug treatments, drugs are considered to be necessary remember:

• All drugs have side-effects that may worsen symptoms.
• Always ask the prescribing doctor why the drug is being prescribed, what the side-effects may be and what you should do if they occur.
• Don't assume that a drug that has proved to be useful at one time will continue to be effective. Dementia is a degenerative condition. The chemistry and structure of the brain will change during the course of the illness.
• Bear in mind that certain combinations of drugs may counteract each other. Remind your doctor if other medications are being taken.
• If a drug is prescribed, check with your doctor that there is a clear plan to review the medication and to stop it as soon as possible. Usually, a trial of stopping drugs is recommended after three months.

Taking drugs

Drugs will be more effective if they are taken exactly as prescribed by the doctor, in the correct dose and monitored regularly for side-effects.

If symptoms are difficult to control, the doctor may refer to a specialist for further advice.

• Some drugs need to be taken regularly to have an effect - for example, antidepressants and major tranquilizers (often called antipsychotics or neuroleptics). These drugs are not helpful when given on an 'as needed basis'. Other drugs, such as hypnotics or anxiety-relieving drugs, may be more effective when taken on an as-needed basis. This should only be done after discussion with the doctor.
• Do not expect immediate results. Benefits may take several weeks to appear, particularly with antidepressants and major tranquilizers.
• Side-effects may occur early or late in the course of treatment - it is important that you ask the doctor what to expect.
• Side-effects are usually related to the dose. The doctor will usually 'start low and go slow', gradually increasing the dose until the desired effects are achieved.
• Once treatment has been established it is important that it is reviewed regularly. Take all medications to the clinic and hospital appointments.
• Remember that some of the drugs taken to control behavioral symptoms can be dangerous if accidentally taken in large quantities. Make sure medicines are kept safe and secure.

Names of drugs

All drugs have at least two names - a generic name, which identifies the substance, and a proprietary (trade) name, which may vary depending upon the company that manufactured it.

More detailed information on medications for treating agitation, aggression and psychotic symptoms.