Beyond the Diagnosis: How Medications Can Help with Dementia Care

When someone you love is diagnosed with dementia, it’s natural to feel overwhelmed. Questions arise quickly: What can be done? Is there a treatment? Will things get better?

In an earlier blog, we explored the many non-medication strategies that can help individuals with dementia feel more comfortable, connected, and engaged. While these therapies often serve as a first line of support, there are times when medication can offer meaningful relief - especially when symptoms interfere with safety, sleep, or quality of life.

While dementia currently has no cure, several medications and emerging therapies can offer meaningful relief. These medical options don’t reverse the condition, but they can reduce symptoms, enhance quality of life, and, in some cases, slow progression - especially when started early.

Let’s walk through the most common and promising medical treatments available today:

Cholinesterase Inhibitors

Medications like donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne) are widely used for Alzheimer’s and sometimes other types of dementia. These drugs work by increasing levels of acetylcholine, a chemical essential for learning and memory.

They are generally prescribed in the early to moderate stages of dementia and can lead to temporary improvements in memory, language, and focus. Common side effects include nausea, upset stomach, and poor appetite, but these often ease with time or adjustment.

Memantine

Memantine (Namenda) is typically prescribed for moderate to severe dementia. It works differently than cholinesterase inhibitors - by regulating glutamate, another neurotransmitter involved in memory and learning.

Memantine may help with attention, daily functioning, and delay the need for more intensive care. It’s often used alongside a cholinesterase inhibitor. Side effects may include dizziness, constipation, and confusion, though many people tolerate it well.

Disease-Modifying Drugs

A new category of treatments targets the biology of Alzheimer’s disease itself. These drugs - lecanemab (Leqembi) and donanemab - are monoclonal antibodies that bind to amyloid plaques in the brain and help clear them away. These plaques are one of the hallmark signs of Alzheimer’s.

Approved only for early-stage Alzheimer’s, these therapies are given via infusion and monitored closely due to potential risks, such as brain swelling or bleeding. Still, they represent a hopeful step forward in slowing the disease, not just managing the symptoms.

“Medications can’t cure dementia - but the right ones can offer better days, clearer moments, and calmer nights.”

Medications for Behavioral Symptoms

As dementia progresses, behavioral and psychological symptoms may emerge: agitation, depression, anxiety, paranoia, even hallucinations. These can be deeply distressing to both the individual and their caregivers.

Because behaviors often stem from unmet needs or discomfort, medications are usually considered after trying personalized, non-drug strategies. When used thoughtfully and with consent from care partners, they can reduce distress and help the person feel safer in their surroundings.

Doctors may recommend:

• Antidepressants to improve mood and reduce anxiety
• Antipsychotics (used cautiously) to address hallucinations or extreme agitation
• Anxiolytics or sleep aids for persistent restlessness or sleep disturbances

These drugs require close monitoring due to side effects like sedation, increased fall risk, or changes in heart rhythm. But when used appropriately, they can restore calm, improve sleep, and help individuals feel more secure in their environment.

It’s important to remember that not every individual with dementia will need medication - and that’s okay. The decision to use medication should always be based on the person’s needs, preferences, and how they respond to other care approaches.

Who Should Be Leading Dementia Care?

Managing dementia medications requires expertise, ongoing monitoring, and a coordinated approach. Typically, a primary care physician is the first to notice cognitive changes and may begin the diagnostic process. From there, a neurologist - who specializes in brain disorders - often takes the lead in confirming a diagnosis and recommending treatment. Geriatricians, who focus on older adult health, are also valuable for managing medications in the context of other age-related conditions. In more complex cases, psychiatrists may assist with behavioral symptoms or co-existing mood disorders.

Regardless of who is prescribing the medications, communication among all providers is essential. A collaborative team - including the family and care staff - helps ensure that treatment is safe, tailored, and regularly reviewed. For families navigating this process, having a dedicated doctor to coordinate care - especially as the disease progresses - can offer both stability and peace of mind.

A Word of Encouragement

Medical treatments for dementia won’t cure the disease, but they can support comfort, clarity, and safety when used as part of a broader, personalized care plan. When thoughtfully combined with non-pharmacological therapies, medications may offer a meaningful boost in quality of life. Reactions to medications vary widely, so regular review and input from trusted care partners is key to ensuring the best outcome.

If you haven’t yet read our blog on holistic approaches to dementia care, we encourage you to start there. At Aegis Living, we believe in supporting the whole person, and working together to find what brings out the best in every individual.