ABSTRACT
Any decision to prescribe is complex and involves the consideration of numerous factors. Most drugs prescribed in dementia are for symptomatic relief or control rather than disease modification. Some drugs have been found to increase the risk of developing dementia. These include drugs with anti-cholinergic properties. This chapter discusses in detail the use of the four medications that are currently licensed in the UK for the treatment of Alzheimer’s Dementia: donepezil, galantamine, rivastigmine and memantine. It also considers their use in Dementia with Lewy Bodies and Vascular Dementia. These drugs’ main role is in slowing the clinical progression of dementia and they are effective in about 50% of people. Behavioural and psychological symptoms of dementia are commonly treated with medication when other methods have been exhausted, although the drugs’ side effects and associated risks often outweigh their benefits. The drugs used include antipsychotics, antidepressants, mood stabilisers, the cholinesterase inhibitors and memantine. Analgesia can also be beneficial when pain is contributing to behavioural symptoms. Recent research into new drugs for dementia has brought very few drugs to market for clinical use but trials are ongoing. Other research methods include investigating medications which may reduce the risk of developing dementia.
