Approximately one-quarter of individuals suffering Alzheimer's disease experience delusions (firmly fixed but false beliefs such as one's spouse being unfaithful or the belief that someone is trying to do one harm). Agitation is also more common as AD progresses. Antipsychotic medications have, at best, been shown to be of moderate benefit for treating psychosis or agitation associated with AD (none are FDA-approved in this regard). The newer (atypical) antipsychotics are aripiprazole [Abilify], olanzapine [Zyprexa], quetiapine [Seroquel], risperidone [Risperidal], and ziprasidone [Geodon]. Caution is warranted as their use has been associated with a small but real increased risk of death when used in elderly with dementia. Benefit and risk must be considered carefully.

Medications approved to treat seizure disorders (epilepsy), such as carbamazepine (Carbatrol, Tegretol and others), valproate (Depakote, Depakene and others) and gabapentin (Neurontin), have sometimes been helpful in managing agitation, even in people who do not have epilepsy.

Depression, commonly seen in Alzheimer's disease, is best managed with newer antidepressants including the selective serotonin reuptake inhibitors or SSRIs (citalopram [Celexa], escitalopram [Lexapro], fluoxetine [Prozac], paroxetine [Paxil] and sertraline [Zoloft]). Bupropion (Wellbutrin), duloxetine [Cymbalta], mirtazapine (Remeron) and venlafaxine (Effexor) are other newer antidepressants often used with elderly patients. Antidepressants and other psychiatric drugs may help specific symptoms, but they are not specific treatments for AD and cannot slow its progression.

back to top