Rusty: You can live your life with the treatment
you get. I suppose the drugs that they give us are obviously doing us good. I know I’m
taking medicine but I just don’t think about it. I think it must be helpful because I really
don’t have too many worries about it. Dan Harwood: There is currently no known cure
for dementia, although there is lots of research going on to find one. However, there are drugs
that will help to treat some of the symptoms of dementia or stop them progressing for a
while. This depends on what type of dementia someone has.
People have Alzheimer’s disease or mixed dementia, where Alzheimer’s is the main cause are usually
offered one of four drugs – donepezil, rivastigmine, galantamine or memantine. These are widely
known by the brand names, Aricept, Exelon, Reminyl and Ebixa but there are others. These
drugs all help to tackle the physical changes in the brain that cause dementia.
The first three, donepezil, rivastigmine and galantamine are usually prescribed to people
who have mild to moderate Alzheimer’s disease or mixed dementia. Some people find these
drugs lessen their symptoms for a while. Benefits can include improvements in motivation, anxiety
levels, confidence, daily living, memory and thinking. These drugs will initially be prescribed
by a specialist, such as a consultant at the memory clinic.
If one of these three drugs causes problematic side effects, it is possible to switch and
try one of the others. People who have moderate Alzheimer’s disease but can’t take any of
the three drugs we’ve just talked about, perhaps because of side effects, might be offered
memantine, known as the brand name Ebixa. It’s also become more common to be offered
memantine in the later stages of Alzheimer’s disease when symptoms become severe.
The benefits of memantine are that it can temporarily slow down the progression of symptoms
in people in the middle and later stages of Alzheimer’s disease. It may also help with
agitation or aggressive behaviour which are more common in more advanced dementia.
The last four drugs I’ve just described that are used for Alzheimer’s disease aren’t effective
for people with vascular dementia. They are only given to people with vascular dementia
when this is part of a mixed dementia with Alzheimer’s disease. It may be possible to
slow down the progression of vascular dementia by taking drugs that treat the underlying
conditions. So the GP will often prescribe drugs for people with vascular dementia who
are at risk of having a stroke or who have high blood pressure, high cholesterol, diabetes
or heart problems. In many cases, the person will already be taking some of these medicines.
If they are experiencing distressing symptoms such as hallucinations, which is where people
see things that aren’t there, or delusions, which is when they believe things that aren’t
true, someone with dementia with Lewy bodies might benefit from one of the three anti-Alzheimer’s
drugs, donepezil, rivastigmine or galantamine. In frontotemporal dementia, the anti-Alzheimer’s
drugs haven’t been shown to offer any benefits and may even be harmful. Because of this,
they shouldn’t be prescribed. It’s common for people with behavioural variant frontotemporal
dementia to be prescribed anti-depressant medication. This can help to reduce some of
the inappropriate obsessive or compulsive behaviours that are common symptoms of frontotemporal
dementia. As with lots of medication, drugs to treat
dementia can cause some side effects. For example, donepezil can cause nausea or diarrhoea.
For more information on side effects, talk to your GP.
Drugs are not the only way to treat or manage the symptoms of dementia. There are many other
things that can help people to live well. Talking therapies, such as counselling or
psychotherapy give people the chance to speak in confidence to a qualified professional
about problems or issues that might be bothering them. They might help you to come to terms
with the diagnosis and identify ways to live well with dementia. They may also help with
symptoms of depression or anxiety. Talking therapies typically involve regular sessions
with a therapist, either one to one or sometimes in a group.
They can be face to face or over the phone. Some people will just have one session while
the others will have therapy that continues for many months. Alongside talking therapies
there are other non-drug approaches that may be helpful as dementia progresses.
Some of the more commonly used ones are reminiscence therapy and life story work and cognitive
stimulation therapy. Reminiscence work involves talking about things
from the past using prompts such as photos, familiar objects or music. It can be one to
one or in a group. Life story work is usually shared between the person with dementia and
a family member, friend or support worker. A scrap book or photo album is used to record
details of the person’s life. These techniques particularly when done one on one can improve
mood, wellbeing and some mental or cognitive abilities such as memory.
At the same time, they can help others to focus on the person rather than their dementia.
The services available and how to be referred to one of them can vary around the country.
Ask your GP, memory service or local Alzheimer’s Society for details of what is available in
your local area. Another non-drug option for people with dementia
is complementary therapy. These therapies are outside of conventional medicine and are
used to treat or prevent illness and promote health and wellbeing. Complementary therapy
should be used alongside and not instead of conventional medicines. Anyone thinking about
trying these therapies should tell their GP. Some examples of therapies that may help people
with dementia are massage, aromatherapy, bright light therapy where you sit in front of a
light box, and music therapy. Ann: I think I worry more about how Rusty’s
feeling in as much as he gets a bit depressed with himself. I think that’s probably my biggest
worry. I think the fact that he worries about he can’t do things like he used to. Like he
gets in a muddle if he tries to change plugs and he can’t get the television to work and
things that he’s always been able to do. So he gets a bit depressed about that side of
it. Dan Harwood: It’s quite common for people
with dementia to experience depression or anxiety, especially in the early stages. People
who have vascular dementia or Parkinson’s disease dementia are more likely to experience
it than people with other types of dementia. There are both drug and non-drug treatments
that can be used for depression and anxiety. Anti-depressants work by correcting the level
of some chemicals in the brain. But research has shown that common anti-depressants don’t
work as well for depression in people with dementia as they do for people that don’t
have dementia. It can take several weeks to notice the benefits
of taking an anti-depressant. Many people experience some side effects to begin with,
but these usually lessen after a week or two. There are other ways to treat depression that
don’t involve taking drugs. These include talking therapies such as counselling, reminiscence
activities and life story work. Other simple things that can help with depression and anxiety
include keeping active, doing activities that you enjoy, and talking to friends and family.
Eating a healthy diet and not having too much alcohol or caffeine can also help.
To find out more about treatments for dementia, visit alzheimers.org.uk/treatment