Ask the Alzheimer’s Expert! Medications to Treat Behavior Problems

Ask the Alzheimer’s Expert! Medications to Treat Behavior Problems

Ask the Alzheimer’s Expert! What Medications Are Used to Treat Behavior Problems in the Alzheimer’s Patient?

Ask the Alzheimer's Expert West Palm BeachAsk the Alzheimer’s Expert is brought to you each week by Elayne Forgie and the Alzheimer’s Care Resource Center.

Question: Are there medications that will help me manage my wife’s behavior?

Answer: Although you didn’t elaborate or explain the type of behavior you are trying to manage, I will give you some general information and ask you to contact your wife’s physician directly:

Sometimes personal care and interactions aren’t enough to sooth challenging behavior or alleviate the symptoms of depression or anxiety. In these cases, your wife’s doctor may prescribe certain drugs that can help improve behavioral symptoms. Although medications such as the following may be of some benefit, they’re often used as a second line of defense in Alzheimer’s. That’s because these drugs can intensify cognitive losses, and their side effects are generally more pronounced in older adults.

Antipsychotics

Medications called antipsychotics or neuroleptics may be used to treat aggression, delusions and hallucinations. Antipsychotics are divided into two major groups: conventional and atypical. Both groups work by blocking certain neurotransmitter receptors, particularly dopamine, in the hopes of regulating emotions. Atypical antipsychotics also act on serotonin, which may be a reason why these medications generally have fewer side effects than convention antipsychotics. Side effects can include muscle spasms, rigidity, tremor and gait disturbance. Antipsychotics also block acetylcholine receptors, which are already in short supply in a person with Alzheimer’s. This action tends to accelerate cognitive decline. Commonly prescribed antipsychotic drugs include:

  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Haloperidol (Haldol)
  • Ridperidone (Risperdal)

Anxiolytics

Sometimes anxiety may be relieved with anxiolytic agents known, as a group, as benzodiazepines. These medications work efficiently in the short term, but there benefits gradually decrease with prolonged use. Some anxiolytics take a few weeks to begin working, which may also limit their use. Side effects can include sleepiness, decreased learning and memory, dizziness and loss of coordination, and possibly even more agitation. Commonly prescribed anxiolytics include:

  • Lorazepam (Ativan)
  • Oxazepam (Serax)
  • Buspirone (Buspar)
  • Zolpidem (Ambien)

Antidepressants

If a person with Alzheimer’s receives a diagnosis of major depression, drug therapy is often recommended. Common side effects of certain antidepressants are anxiety and agitation, and so they should be used with caution in people who already exhibit these symptoms. Other side effects include insomnia, tremor, nausea, diarrhea, headache, decreased appetite, dizziness, sweating and dry mouth, These side effects may go away on their own.

  • Fluoxetine (Prozac)
  • Paroxeine (Paxil)
  • Sertraline (Zoloft)
  • Trazodone (Desyrel)

source: Mayo Clinic and Alzheimer’s Association