Module 1: Introduction to Dementia
Module 2: Dementia Stages and Assessment
Module 3: Behavioral Symptoms and Non-Pharmacological Therapies
Module 4: Palliative Care and Medication Use in Dementia Care
Module 5: Dementia and Caregiving
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4.5 The Role of Medicine

Although there is no cure for dementia, medications play a significant role in the lives of those who have it, primarily through managing symptoms. Some dementia patients might also be given medication for concurrent health issues, including type 2 diabetes mellitus or high blood pressure.
Given their cognitive issues, it should be no surprise that managing medications are complex for those with dementia, which can lead to medication errors, hospital admissions, and dependence on others.
The majority of drugs prescribed to manage challenging behaviors fall into one of the following categories:

  • Antipsychotic drugs – These drugs were initially created to treat schizophrenia and other conditions characterized by signs of psychosis.
  • Benzodiazepines – This group of drugs has a relatively quick sedative effect. Therefore, these medications are used to treat sleeplessness as well as anxiety and panic episodes. They are easily able to develop into habits.
  • Mood Stabilizers – These include drugs typically used to treat seizures. They typically lessen brain cells’ “excitability.”
  • Anti-depressants – These are beneficial for reducing anxiety. However, they take weeks or even months to reduce the symptoms of anxiety or depression entirely.
  • Anti-convulsants – They are a particular kind of medication that works by regulating the brain’s abnormal electrical activity to prevent or treat seizures or convulsions.
  • Dementia Drugs – These are the medications the FDA has approved for treating Alzheimer’s-related memory and cognitive issues. They appear to assist with some neuropsychiatric symptoms in some patients.
  • Anticholinergic Medications – These include numerous routinely prescribed medications, including those for urine incontinence, depression, asthma, and heart issues, which block a brain chemical called a neurotransmitter that has an impact on numerous bodily systems.

Patients who have been prescribed drugs for the symptoms of dementia should be evaluated every three to six months to see if the medications are working as intended in lowering the symptoms.
If the intended behaviors have not demonstrably decreased, medications with minimal to no effects should be reduced or discontinued.
For instance, statins should be discontinued at 80 or 90 because they no longer provide significant benefits. Antihistamines and other sleep aids like diphenhydramine are also harmful to those with dementia and should be stopped.

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