Understanding What Drug Is Used to Slow Down Dementia Progression

October 11, 2025 •

5 min read

While there is no cure for most progressive dementias, medications can be used to manage symptoms and temporarily slow their worsening. Understanding what drug is used to slow down dementia involves examining different pharmacological classes that target specific brain processes to stabilize cognitive and functional abilities for a period of time.

Quick Summary

This article explains the different types of medications used to manage dementia symptoms and temporarily slow progression, including cholinesterase inhibitors, NMDA receptor antagonists, and newer anti-amyloid therapies. It details how each class of drug works, its target stages, and potential side effects.

Key Points

Symptom Management: Older medications like cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine focus on regulating brain chemicals to temporarily manage cognitive and functional symptoms of dementia.
Disease Progression: Newer anti-amyloid antibody drugs, such as lecanemab and donanemab, are used to actively remove plaques in the brains of people with early-stage Alzheimer's to slow disease progression.
Targeting Specific Stages: Cholinesterase inhibitors are typically for mild-to-moderate dementia, while memantine is for moderate-to-severe. Anti-amyloid therapies are specific to early-stage Alzheimer's.
Side Effects Vary: Medication side effects differ by class, with cholinesterase inhibitors often causing gastrointestinal issues and anti-amyloid drugs carrying a risk of brain swelling or bleeding.
Holistic Approach is Key: Effective dementia care combines medication with non-pharmacological strategies like exercise, cognitive stimulation, and environmental adjustments to improve quality of life.
Ongoing Research: The field of dementia pharmacology is evolving, with new therapies like anti-amyloid antibodies representing a shift toward disease-modifying treatments.

Medications for Slowing Dementia Progression

Dementia is a broad term describing a range of symptoms, including memory loss and impaired thinking, that are severe enough to interfere with daily life. While there is currently no cure for the most common forms of dementia, including Alzheimer's disease, medications are available that can help manage symptoms and temporarily slow cognitive decline. These drugs do not reverse the underlying disease process but can provide meaningful benefits, improving a person's quality of life and potentially delaying the need for higher levels of care. Treatment strategies often involve a combination of medication and non-pharmacological therapies tailored to the individual's specific needs and type of dementia.

Symptomatic Treatments: Targeting Brain Chemicals

The primary class of medications historically used to address cognitive symptoms in dementias, particularly Alzheimer's disease, is cholinesterase inhibitors. These drugs work by affecting the brain's chemical messengers to support communication between nerve cells.

Cholinesterase Inhibitors

Nerve cell damage in conditions like Alzheimer's and Lewy body dementia can lead to a decrease in acetylcholine, a neurotransmitter critical for memory and learning. Cholinesterase inhibitors prevent the breakdown of acetylcholine, thereby increasing its levels in the brain and helping nerve cells communicate more effectively.

Common cholinesterase inhibitors include:

Donepezil (Aricept): Approved for treating mild, moderate, and severe Alzheimer's disease.
Rivastigmine (Exelon): Used for mild-to-moderate Alzheimer's and mild-to-moderate dementia associated with Parkinson's disease. It is available in capsule and transdermal patch forms.
Galantamine (Razadyne): Prescribed for mild-to-moderate Alzheimer's disease.

NMDA Receptor Antagonists

Memantine (Namenda) is another medication that works on a different brain chemical, glutamate. In dementia, excessive levels of glutamate can damage nerve cells. Memantine works by blocking the toxic effects of excess glutamate and regulating its activity.

Memantine (Namenda): Typically prescribed for moderate-to-severe Alzheimer's disease, it can help stabilize mental functions and delay the loss of daily living abilities.
Combination Therapy: Memantine can be prescribed in combination with a cholinesterase inhibitor like donepezil (Namzaric) for treating moderate-to-severe Alzheimer's.

Disease-Modifying Therapies: Targeting Underlying Pathology

Recent advancements have introduced medications that address a core pathological feature of Alzheimer's disease: the buildup of beta-amyloid plaques. These are considered disease-modifying therapies because they target the biological cause of the disease, rather than just its symptoms.

Anti-Amyloid Antibodies

These treatments, administered via intravenous (IV) infusion, are approved for people with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease who have confirmed amyloid plaques in the brain. They work by removing these plaques to reduce cognitive decline.

Lecanemab (Leqembi): An anti-amyloid antibody that removes beta-amyloid plaques. Clinical trials have shown it can slow the rate of cognitive and functional decline in early Alzheimer's.
Donanemab (Kisunla): Also an anti-amyloid antibody, it targets beta-amyloid to slow progression in early Alzheimer's.

These newer drugs come with specific side effect risks, including amyloid-related imaging abnormalities (ARIA), which can cause brain swelling or bleeding. Close monitoring, including brain MRIs, is necessary.

Adjunctive Medications for Behavioral and Psychological Symptoms

Beyond cognitive decline, dementia often leads to behavioral and psychological symptoms (BPS), such as agitation, depression, anxiety, and sleep disturbances. Medications can be prescribed to manage these issues, often after trying non-drug strategies first.

Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression, which can exacerbate dementia symptoms.
Anti-anxiety Medications: Can help with anxiety and restlessness but must be used with caution in older adults.
Antipsychotics: Prescribed for severe agitation, paranoia, or hallucinations, but carry a black box warning about increased risk of death in older adults with dementia-related psychosis.

Comparing Dementia Medications


Feature	Cholinesterase Inhibitors	NMDA Receptor Antagonist (Memantine)	Anti-Amyloid Antibodies (Lecanemab, Donanemab)
Mechanism of Action	Boosts levels of the neurotransmitter acetylcholine by preventing its breakdown.	Regulates the activity of the neurotransmitter glutamate, protecting nerve cells from damage.	Removes beta-amyloid plaques from the brain to reduce cognitive decline.
Primary Target	Symptoms of mild-to-moderate Alzheimer's disease, Lewy body dementia, and Parkinson's disease dementia.	Symptoms of moderate-to-severe Alzheimer's disease.	Underlying pathology in early-stage Alzheimer's disease (MCI or mild dementia).
Common Side Effects	Nausea, vomiting, diarrhea, loss of appetite, insomnia, and fatigue.	Dizziness, headache, confusion, and constipation.	Brain swelling or bleeding (ARIA), infusion-related reactions, and headache.
Effect	Can temporarily improve or stabilize cognitive function.	Can help maintain some daily functions for a longer period.	Can slow the progression of the underlying disease.

Non-Pharmacological Strategies and Lifestyle

Medication is only one part of comprehensive dementia care. Non-drug approaches are crucial for managing symptoms and improving quality of life.

Physical Activity: Regular exercise can improve strength, balance, and mood. Some research suggests it may also help slow the progression of cognitive decline.
Cognitive and Social Engagement: Stimulating the brain through activities and social interactions is important for maintaining mental sharpness.
Occupational Therapy: A therapist can suggest ways to make the home safer and adapt daily activities to evolving abilities.
Environmental Adjustments: Reducing clutter and noise can help minimize confusion. Consistent routines are also beneficial.
Healthy Diet: A balanced diet rich in vitamins and nutrients supports overall brain health.
Adequate Sleep: Establishing a consistent sleep routine is important for brain health and can help manage nighttime restlessness.

Conclusion

While there is still no cure for most progressive forms of dementia, medications offer valuable tools for managing symptoms and temporarily slowing down the rate of decline. Cholinesterase inhibitors and NMDA receptor antagonists help regulate brain chemicals to address cognitive and functional symptoms, while newer anti-amyloid antibodies target the root cause of Alzheimer's in its early stages. The optimal approach is personalized and often involves a combination of medication, lifestyle adjustments, and supportive therapies to maximize quality of life for individuals living with dementia. Given the ongoing research, new treatments continue to emerge, offering hope for more effective interventions in the future.

For more information on dementia care and support, you can visit the Alzheimer's Association website.

The Role of Personalized Care

Since no single medication is a one-size-fits-all solution, the use of dementia drugs must be tailored to the individual. Factors like the specific type of dementia, its stage, the person's overall health, and their tolerance to side effects all influence the treatment plan. It is crucial for families and caregivers to work closely with healthcare providers to monitor symptoms and side effects and to adjust medications as needed.

Important Considerations for Treatment

When considering medication for dementia, it is important to have realistic expectations. The benefits are often modest and temporary, and the drugs cannot halt the disease indefinitely. However, even a temporary stabilization of symptoms can provide significant relief to both the person with dementia and their caregivers. The decision to start, continue, or stop medication should be a collaborative one between the patient, their family, and their healthcare team. Non-drug interventions remain a cornerstone of management throughout the disease course.

Frequently Asked Questions

The drugs used to slow dementia are typically categorized into cholinesterase inhibitors (donepezil, rivastigmine, galantamine) for mild-to-moderate stages and NMDA receptor antagonists (memantine) for moderate-to-severe stages. Newer anti-amyloid antibodies like lecanemab are specifically used to slow early-stage Alzheimer's progression.

No, currently, there are no medications that can stop or reverse the progression of most types of dementia, including Alzheimer's disease. The available drugs can only temporarily slow down the worsening of symptoms and help manage cognitive functions for a period of time.

Cholinesterase inhibitors increase levels of acetylcholine in the brain to aid in memory and learning. NMDA receptor antagonists, like memantine, regulate glutamate activity to protect nerve cells from damage, which is used for more advanced dementia.

Common side effects vary by medication. Cholinesterase inhibitors can cause nausea, vomiting, and loss of appetite, while memantine's side effects include dizziness and headache. Newer anti-amyloid drugs have potential side effects like brain swelling and bleeding.

No, anti-amyloid treatments such as lecanemab and donanemab are specifically approved for use in the early stages of Alzheimer's disease, including mild cognitive impairment (MCI) or mild dementia. They are not effective for later stages.

No, non-pharmacological interventions are a crucial part of dementia treatment. These include physical activity, cognitive stimulation, occupational therapy, and environmental adjustments, which can help manage symptoms and improve quality of life.

Not every patient responds the same way to dementia medication. For some, the benefits are significant, while others may experience only a minor or unnoticeable difference. A doctor will determine the best course of action based on the individual's specific needs and tolerance.