Alzheimer's Medication: What Helps and What to Watch For

Alzheimer's drugs won't cure the disease, but the right ones can slow symptoms, help thinking, and make daily life easier for months or years. If you're managing the diagnosis for yourself or someone else, knowing how each medicine works and what to watch for makes treatment more useful and less stressful.

How common Alzheimer's drugs work

There are two main groups of medicines you’ll hear about. Cholinesterase inhibitors — sold as donepezil (Aricept), rivastigmine, and galantamine — raise levels of a brain chemical important for memory and attention. They help mostly with mild to moderate symptoms and sometimes improve daily tasks.

Memantine (Namenda) works differently. It calms overactive brain signals and is used for moderate to severe Alzheimer’s. Doctors sometimes combine memantine with a cholinesterase inhibitor when symptoms progress.

Recently approved drugs called anti-amyloid therapies — for example lecanemab (Leqembi) — target amyloid plaques in the brain. They aim to slow disease progression rather than just ease symptoms. These treatments require special testing, regular MRIs, and careful discussion with your neurologist about benefits and risks.

Side effects, interactions, and red flags

Common side effects are usually mild but worth knowing. Cholinesterase inhibitors can cause nausea, diarrhea, sleep trouble, and sometimes slow the heart rate. Memantine may cause dizziness, headaches, or confusion. Anti-amyloid drugs can cause brain swelling or small bleeds (called ARIA), so doctors monitor with scans.

Watch for interactions: anticholinergic drugs (many sleep aids, some allergy pills, and bladder medicines) can cancel out cholinesterase inhibitors and worsen confusion. Beta-blockers and some heart meds combined with cholinesterase inhibitors can increase fainting risk. Always review every prescription and over‑the‑counter drug with the prescriber or pharmacist.

If you notice sudden worsened confusion, fainting, new seizures, severe headache, or unexplained weakness, contact the clinic or emergency care. For anti-amyloid treatments, MRI follow-up and lab checks are part of safe use.

Practical tips for patients and caregivers

Use a single pill organizer or synchronized refill plan so doses aren’t missed. Keep a short symptom log — mood, appetite, sleep, and any side effects — and bring it to appointments. Ask the doctor about realistic goals: are you aiming to improve daily function, slow decline, or both? That helps pick the right drug.

Check costs and coverage early. Newer disease-modifying drugs can be expensive and need insurer approval. If swallowing is hard, ask about liquid forms or pharmacists who can advise on safe alternatives.

Finally, involve a pharmacist and the care team. They’ll help spot interactions, adjust doses when other illnesses come up, and support safe medication changes. Good communication makes these medicines do more good and cause less harm.