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Dementia- Medication



"There unfortunately are only two approved FDA medication classes for dementia. These medications were developed initially for Alzheimer's disease and they have found use in all types of dementia. The first category of medications for dementia are the acetylcholine esterase inhibitors. What these medications do is inhibit the enzyme acetycholine esterase in the brain, thereby increasing the amount of acetylcholine in the brain. Decreasing amounts of this chemical in the brain are associated with the progression of dementia. Acetycholine esterases include Donepezil. These medications unfortunately do not reverse the process of dementia, but they can slow it significantly. We utilize them to help maintain cognitive function for as long as possible. So people can retain their independent functioning. The other class of medication available, NMDA receptor antagonists, are felt to help slow the progression of dementia because they reduce activity at NMDA receptors.

Excessive activity at these receptors is implicated in the progression of dementias, particularly in Alzheimer's disease. However, these medications are generally reserved for people with more moderate stage or later stage dementias. Common side effects of the acetylcholine esterase inhibitors such as Donepezil that it can include nausea and vomiting. We try to avoid that by starting the dose low and increasing it after a certain number of weeks. Other common side effects include vivid dreams, and in some rare cases it can lower heart rate. An amenda, or an NMDA receptor antagonist, is generally very well tolerated, but can cause some dizziness and headache."

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