Dementia Medication: What Works, What to Expect

Dementia affects memory, thinking and daily life—there's no cure, but some medications can slow symptoms and help people stay independent longer. Want a quick guide to the drugs doctors use, what they do, and how to manage risks? Read on for straight talk and practical tips you can use today.

First line treatments are cholinesterase inhibitors. Donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) boost signals in the brain that help memory and thinking. They often ease symptoms for months to years, especially in mild to moderate Alzheimer’s disease. Expect modest benefit: they can make daily tasks easier for some people but won't stop the disease.

Memantine (Namenda) works differently and is usually for moderate to severe stages. It can help with attention and ability to perform daily tasks when combined with a cholinesterase inhibitor. Side effects for these drugs include nausea, dizziness, sleep changes and, rarely, heart rate changes—so monitoring by a doctor is essential.

Risks, interactions, and practical tips

Many people with dementia take multiple medicines. That raises the risk of bad interactions. Anticholinergic drugs, some sleep aids and certain antihistamines can worsen confusion. Always give your full medicine list to the clinician and ask which drugs can be stopped or switched. Start low and go slow with doses, and track side effects on a simple checklist you share at each visit.

Behavior symptoms like agitation or hallucinations are common, but antipsychotics carry serious risks in older adults and are usually a last resort. Non-drug strategies—routine, exercise, lighting, and clear communication—often work well and have no medication side effects. If drugs are needed, discuss benefits versus risks with the care team and set clear goals for what counts as improvement.

Buying meds, costs, and what to ask

If you shop online, use a reputable pharmacy and check for proper licensing and pharmacist access. Compare prices, ask about generic options, and confirm the exact drug name, dose, and refill rules before you buy. Never stop or change dementia medication without talking to the prescriber—sudden changes can cause rapid decline or new symptoms.

Some dementia drugs need no regular blood tests, but heart rate and weight checks matter. Donepezil and other cholinesterase inhibitors can slow the heart in frail adults, so report fainting or new dizziness right away. Rivastigmine patches may irritate skin; rotate sites. Avoid unproven supplements—natural doesn't mean safe; some herbal products interact with prescriptions. If you’re curious about trials or new drugs, ask the neurology clinic about ongoing studies and what criteria look like. Planning ahead—power of attorney, medication wishes and clear instructions—makes medication decisions easier when cognition worsens.

Caring for someone with dementia is a marathon, not a sprint. Regular reviews, medication reconciliation, and small lifestyle steps add up. Keep a simple chart with daily meds, doses, and notes about sleep, appetite and behavior—this helps clinicians make better decisions faster. Need help? Contact a pharmacist or your doctor today.