Treatment Options
There is no cure for Alzheimer’s. However, medications can be prescribed to slow the progression of the disease or manage its symptoms.
Two new amyloid-targeting medications, Aduhelm (aducanumab) and Leqembi (lecanemab), aim to slow the decline of memory, thinking, and function by addressing the underlying biology of the disease. They work by attaching to and removing beta-amyloid, a protein that accumulates into plaques in the brain. Patients taking these infused medications have seen a change in the course of their disease, giving them more time to live independently. There are side effects, however, including serious allergic reactions, infusion reactions, headaches, and falls.
Other Alzheimer’s medications that can help residents living with the disease include:
Side effects associated with these medications may include diarrhea, nausea, or vomiting; decrease in appetite; or decreased heart rate.
Staff should be aware of these side effects as well as potential administration guidelines, including:
- Do not crush medications, which can affect the rate of absorption
- Interruption of dosing for more than three days may require a re-titration
- Slow titration is used to reach higher doses
- Some doses may need to be changed in worsening liver and kidney disease
Medications that may be prescribed for symptom control and to improve residents’ quality of life include:
- Psychosis/Hallucinations: Aripiprazole, Olanzapine, Quetiapine, Risperidone, Ziprasidone, Pimavanserin
- Depression: Citalopram, Escitalopram, Bupropion, Duloxetine, Mirtazapine, Paroxetine, Sertraline, Venlafaxine
- Anxiety: Lorazepam, Oxazepam
- Insomnia: Trazodone, Ambien, Sonata
Outside causes of the symptoms should be ruled out and non-drug interventions considered before starting another medication since many of these drugs come with their own risk profiles. It is important that the resident and their family discuss the benefits and risks of these medications with the prescriber to make the best person-centered decision.