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It is important to work closely with a physician when determining the best treatment. He or she can help develop the most effective and individualized medication programs.
The most common types of progressive dementia are Alzheimer’s disease (AD), vascular dementia, Lewy Body dementia (LBD), and frontotemporal dementia (FTD).
Although there are currently no cures for these diseases, there are medications available to help manage the symptoms of the disease. In some cases, medications available can help slow the progression of cognitive decline.
These medications may help maintain cognitive abilities and control certain behavioral symptoms, helping the person function at a higher level for a longer period of time.
rivastigmine (Excelon®), and galantamine (Razadyne®)
+ Approved for mild to moderate AD
+ Approved for all stages of AD
+ Approved to treat moderate to severe AD
+ Approved to be prescribed in conjunction with any of the other three drugs
There are no specific medications approved by the FDA for the treatment of vascular dementia at this time. However, if the risk factors that may have contributed to vascular dementia are treated and controlled, then the progression may be slowed.
Many of the medications approved to treat Alzheimer’s disease may also help people with vascular dementia. These medications include donepezil, galantamine, rivastigmine, and memantine.
The major risk factors for vascular dementia are:
Physicians who treat Lewy body dementia (LBD) consider cholinesterase inhibitors— donepezil, galantamine, and rivastigmine—to be the best medication options in treating cognitive and psychiatric symptoms.
In clinical studies, each of these medications were equally effective in improving cognitive behavioral symptoms and functional ability without an increase in Parkinsonism.
For Parkinson’s-like muscular symptoms, these medications can help reduce symptoms. However, they can also increase confusion and hallucinations.
Clonazepam and melatonin have both shown effectiveness in treating LBD. Thus, your physician may recommended these medications to treat the REM behavior disorder associated with LBD.
Note: Approximately half of the people with LBD have a dangerous sensitivity to antipsychotic medications. This reaction can cause severe Parkinson’s-like symptoms and confusion. Antipsychotic medications are sometimes prescribed, but should be used cautiously.
There is no cure for FTD, and in most cases its progression cannot be slowed.
Although no medications have been proven effective specifically for FTD, many clinicians look to the medications and treatment approaches used in similar disorders to develop a therapeutic approach.
For example, some FTD patients benefit from antidepressants such as selective serotonin reuptake inhibitors. Another type of antidepressant, such as trazodone, may reduce behavioral symptoms.
People with progressive aphasia may benefit from speech therapy to learn alternate communication strategies.