Understanding Medications for Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia, affecting over 425,000 Australians. With our ageing population, this number is expected to rise to over one million by 2056. If you or a loved one has been diagnosed with Alzheimer’s disease, you might be wondering what treatments are available and how they can help.

This blog post offers a clear, practical guide to the medications used for Alzheimer’s disease, how they work, what to expect, and important things to know when managing treatment.

What Is Alzheimer’s Disease?

Alzheimer’s disease causes gradual damage to the brain. It affects memory, thinking, behavior, and the ability to carry out everyday tasks. While there is currently no cure, some medications can help manage symptoms for a time.

What Medications Are Available?

There are two main types of medications used in Australia to treat symptoms of Alzheimer’s disease:

1. Acetylcholinesterase Inhibitors (AChEIs)

These medications help boost levels of a brain chemical called acetylcholine, which is important for memory and learning. They may slow down symptom progression in mild to moderate stages.

• Examples:

  • Donepezil (Aricept)

  • Galantamine

  • Rivastigmine (available as a patch or capsule)

• Common side effects: Nausea, diarrhea, loss of appetite, dizziness, vivid dreams, slow heart rate

• Important to know: These are not suitable for everyone. People with certain heart, stomach, or breathing conditions may need to avoid them. They also may interact with other medications—especially those with "anticholinergic" effects, which can worsen confusion.

  
  

2. Memantine

Memantine works differently by regulating another brain chemical called glutamate. It’s used in moderate to severe stages of Alzheimer’s disease, especially if AChEIs are not tolerated.

• Common side effects: Dizziness, confusion, headache, constipation

• PBS subsidy: In Australia, memantine is only subsidized when used on its own (not in combination with other dementia medicines) for people with specific levels of memory loss.

Do These Medications Cure Alzheimer’s?

No. These medications do not cure Alzheimer’s disease or stop it from progressing. However, they can:

• Delay worsening of symptoms for some people

• Help with memory, thinking and daily functioning

• Support quality of life—for a time

That said, not everyone benefits from them. Around 30–50% of people may see little to no benefit, while others may experience noticeable improvement.

When Should Treatment Be Reviewed?

After starting medication, your doctor will:

• Check for side effects in the first few weeks

• Assess benefit within 6 months (required for continued PBS subsidy)

• Review regularly (every few months) to monitor memory, behaviour and wellbeing

If there's no clear benefit or if side effects are troublesome, stopping or switching medications may be considered.

Can These Medications Be Stopped?

Yes. Doctors may suggest gradually stopping treatment if:

• Memory and function continue to decline

• The person enters advanced stages with little meaningful benefit

• Side effects or other health issues make treatment risky

It’s important to taper off medications slowly (usually over several weeks) unless there's an urgent reason to stop.

What About Behavioral Symptoms?

Alzheimer’s disease can also cause behavioral and psychological symptoms (known as BPSD), like:

• Agitation or aggression

• Depression or apathy

• Hallucinations or sleep issues

These symptoms can be distressing for both the person and their faimily.

First-line treatment is always non-medication strategies, such as:

• Regular routines

• Social engagement

• Music or art therapy

• Managing pain, discomfort or infections

If medications are needed, doctors may trial:

• Antidepressants (like citalopram) – for mood or agitation

• Antipsychotics (like risperidone) – for severe symptoms, short-term use only due to risk of stroke and other serious side effects

These are used with caution, and always reviewed regularly.

Managing medications can be challenging for someone living with dementia. Here are some helpful strategies:

✅ Use a Webster-pack or pill organizer

✅ Keep an up-to-date list of all medicines

✅ Involve carers and family in medication routines

✅ Set reminders (e.g. phone alarms, fridge notes)

✅ Simplify doses (once daily if possible)

✅ Check for any over-the-counter medications that may interfere

Should I Try Other Supplements or Therapies?

You may hear about other treatments like ginkgo biloba, vitamin E, omega-3, Souvenaid, or anti-inflammatory drugs.

Current evidence does NOT support the routine use of these for Alzheimer’s disease, and some may even be harmful or interact with other medications.

Always talk to your doctor or pharmacist before starting any new supplement or therapy.

Need Help?

If you're caring for someone with dementia, or living with it yourself, you're not alone.

• Visit Dementia Australia for information and support

• Call the National Dementia Helpline: 1800 100 500

• Talk to your GP, pharmacist, or aged care provider for a personalized Home Medication Review.