Once you find out a loved-one has been diagnosed with Alzheimer's disease, it's only natural to learn as much as possible about the condition — and to research treatment options for Alzheimer's in detail.
Alzheimer's disease is very common, and it is expected to become even more frequent in the coming generations. There is currently no cure for the disease and the medical community is still unsure as to what actually causes Alzheimer's disease in the first place.
That is extremely frustrating for both patients and their families, because as Alzheimer's disease progresses, so do cognitive impairments such as memory loss and reduced thinking skills. Complex tasks become harder and harder to complete, and a patient may not remember what you told them just a while ago.
Medications that will help improve life with Alzheimer's: Acetylcholinesterase inhibitors
The first group of medications that will help patients who are suffering from Alzheimer's disease is called acetylcholinesterase inhibitors. It may be an intimidating name to spell, but it is worth noting these medications down as a treatment option to improve cognition in patients with Alzheimer's disease.
Acetylcholinesterase inhibitors are considered to be the first-line treatment when a patient is diagnosed with a mild to moderate form of Alzheimer's disease. Some of the better-known medications that are part of this category of drugs are known as donepezil, galantamine and rivastigmine.
Numerous studies have been carried out to review the effectiveness of these medications, and in the 11 clinical trials dedicated to assessing the effectiveness in cognitive improvements for patients suffering from Alzheimer's disease, improvements were noted in all of them.
In a nutshell, the brain is able to send messages from neuron to neuron using the chemical known as acetylcholine (ACh.) This ACh binds to receptors on the next neuron so that a message can be transferred from one part of the brain to another. Then, within a few moments, an enzyme known as acetylcholinesterase is secreted to break down the chemical to prepare for a new message.
When the brain begins to deteriorate in Alzheimer's patients, these receptors that catch ACh begin to dwindle in number and disappear, and messages will not be sent throughout the brain as easily as before. These medications work by blocking the enzyme from breaking down ACh so there is more time to send the message from one neuron to another.
Medications that will help people with Alzheimer's disease: Memantine
Another class of medications proven to benefit patients' cognition when suffering from Alzheimer's disease would be memantine. This drug is considered a second-line therapy for patients, meaning that it will not be as effective as drugs belonging to the group of acetylcholinesterase inhibitors. That does not mean that memantine should not be considered for patients diagnosed with Alzheimer's, even at the start of treatment, however.
Four different clinical trials determined that memantine can be an effective weapon to help improve the cognition of a patient with Alzheimer's disease. It works on a different pathway compared to acetylcholinesterase inhibitors and as a result, memantine is often combined with these drugs to have a more pronounced impact.
Memantine works by blocking receptors in the brain known as NMDA receptors. These are receptors that naturally increase brain activity and secrete a chemical known as glutamate. When the brain is damaged, it is unable to stop levels of glutamate from becoming higher and higher so the brain essentially begins to short-circuit if left unchecked. By blocking these receptors, the brain is able to function more effectively and cognition will improve.
Medications that will help Alzheimer's patients: N-Methyl-d-Aspartate Receptor Enhancers
This is a medication that works on the same receptors that memantine targets but in this case, it will increase the activity of the receptor but under more strict control. The most common medication in this category goes by the name of sodium benzoate.
One clinical trial designed to assess the improvements in cognition in patients suffering from Alzheimer's disease determined that after a six-month investigation, patients have higher scores on cognition testing compared to patients not taking sodium benzoate. The caveat is that it will only be effective in the early stage of Alzheimer's disease.
Alzheimer's is quite difficult to diagnose, and is often referred to as a diagnosis reached by exclusion. Once doctors run multiple tests and can't identify another likely explanation for a patient's symptoms, Alzheimer's will be the condition that most doctors will arrive at by default. As a result of this lengthy diagnostic process, most patients finally diagnosed with the condition will already have reached a mild or even moderate level of Alzheimer's disease. The damage to the brain may already be quite extensive and sodium benzoate may not be effective at this point.
Medications that will not improve cognition in Alzheimer's disease patients: What do you need to stay away from?
The three groups of medications that we have focused on above are the only medications currently on the market that will actually improve cognition scores in patients suffering from Alzheimer's, as confirmed by extensive scientific research. That does not mean that those are the only medications for Alzheimer's that you may hear about, or read about online as "helpful" treatment options.
Drugs like antipsychotics, dopamine agonists, nicotine, erythropoietin, selective estrogen receptor modulators and DHEA have all been touted as potential options to help improve cognition in patients suffering from Alzheimer's, but all lack data to confirm these claims. They may be helpful for various other aspects of symptoms that patients may experience as their brain begins to deteriorate, but should not be considered as options to improve cognition.
Various supplements available at pharmacies have also been advertised as viable options to improve cognition but they also lack data to supports these claims. Remember that supplements in pharmacies do not have to meet the same stringent benchmarks that medications must meet to be called effective, and side effects are also not typically tested in these drugs. As a result, they can be much more dangerous compared to drugs that require a prescription. Be wary of these false claims as well when seeking drugs to improve cognition.