Drug treatments
Drug treatments for people living with dementia – a brief summary
There are many factors which impact the safety and efficacy of drug metabolism in different people. It is recommended that medical advice be sought about any drug treatment, to discuss possible benefits and side effects of treatment. Professional oversight is recommended when a new medication is started, with ongoing review for the duration of the treatment.
Historically, the prescription of diagnosis-specific medication for people living with dementia was focused primarily on alleviating the symptoms to some degree, rather than curing the disease itself. For example, medication to reduce anxiety, agitation or depression, or to minimise the experience of hallucinations or delusions has been helpful for some people living with different types of dementia for many years.
The licensing of donepezil (Aricept) in the UK in 1997 marked the start of a new era of treatment options for people living with Alzheimer’s disease. Donezepil is a drug which works by increasing the amount of a chemical messenger called acetylcholine in the brain, which helps brain cells communicate between each other. In Alzheimer’s disease, acetylcholine levels are reduced, which causes difficulties with memory and thinking. By preventing the breakdown of acetylcholine, donepezil helps maintain higher levels and increases its availability in the brain. This has the potential to improve cognitive function and symptoms. It is important to note that donepezil treats the symptoms related to Alzheimer’s disease, not the disease itself.
Rivastigmine and galantamine were subsequently licensed in the UK for the treatment of Alzheimer’s disease. These drugs work in a similar way to donepezil and are used mainly in the early to middle stages of the disease.
Memantine is another medication which is prescribed for people living with Alzheimer’s disease. Memantine works on different neurotransmitters to the previously mentioned drugs. People with Alzheimer’s disease can have too much of a chemical called glutamate. This damages their nerve cells and makes it harder for them to send messages. Memantine protects a person’s nerve cells by blocking glutamate.
This medication is sometimes given in combination with other dementia medications, or as a standalone prescription for some people.
These drugs are now relatively commonly prescribed for people living with Alzheimer’s disease, and sometimes for people living with Lewy body dementia (LBD).
Disease-modifying drugs
More recently, dementia drug treatment possibilities for people living with Alzheimer’s disease moved forward significantly, with the discovery that abnormal deposits of amyloid can be cleared from the brain using monoclonal antibody drugs (namely lecanemab and donanemab) under clinical trial conditions. This is the first time that drugs have been found to treat the underlying disease, rather than just targeting the symptoms.
Alzheimer’s disease is caused by an accumulation of two abnormally folded proteins within the brain: amyloid protein and tau protein. When amyloid proteins fold abnormally, they malfunction and cause sticky amyloid plaques to be laid down in the brain. When tau proteins fold abnormally, they create tangles of malformed tau which affect the shape and function of the brain cells.
Both these proteins seem to be related in some way to inflammation that spreads within different networks throughout the brain and which ultimately cause brain cells to malfunction, fail to work effectively, and ultimately die. It is the death of these brain cells (neurons) that show up as abnormalities on brain scans.
Being able to use these drugs to slow down or stop the production of abnormal amyloid holds promise for the future treatment of Alzheimer’s disease. At the time of writing (2026), neither lecanemab nor donanemab are available as NHS treatments in the UK. They are available privately.
The developments of these potential treatments for Alzheimer’s disease cause people to ask about the possibilities of treatments for other types of dementia. There are well over a hundred different drugs in clinical drug trials for the treatment of dementia and many of the scientific and medical communities are excited at the prospect of new treatments in the future. Clinical drug trials typically require an investment over many years from drug companies, healthy volunteers and people living with dementia before a drug is licensed for use. You can find out more about clinical trials on the Alzheimer’s Society website.
Unlike the cause of the symptoms in Alzheimer’s disease (amyloid and tau proteins), Lewy body dementia (LBD) and frontotemporal dementia (FTD) are caused by the presence of proteins other than amyloid and tau. There are currently no licensed drug treatments for these diagnoses. In fact, people with FTD can respond badly to the currently licensed Alzheimer’s disease drugs, and the prescription of them for people with FTD is contraindicated, meaning that they generally shouldn’t be prescribed. On the other hand, some people with LBD do benefit from the drugs that prevent acetylcholine levels from dropping in Alzheimer’s disease, such as Donepezil.
Primary Progressive Aphasia (PPA) is an umbrella term with includes semantic variant PPA (svPPA), non fluent variant PPA (nfvPPA) and logopenic variant PPA (lvPPA). In lvPPA, the underlying pathology is the same as in Alzheimer’s disease (amyloid and tau) and where this is the case, the licensed treatments for Alzheimer’s disease may have some impact on the symptoms. For svPPA and nfvPPA there are currently no licensed medications in the UK, although there are ongoing drug trials for FTD, the underlying cause of both these conditions.
While research into drug treatments for the wide range of dementia diagnoses continues, it is important that we maximise other types of non-drug therapies, adapt home and social environments and raise awareness of dementia among the people in our wider social networks. There is much that can be done to positively impact the symptoms of dementia and help people living with them to function as well as possible, outside of drug treatments per se. See the RDS website page on living well and empowerment for further information.
For more information about drug treatments for dementia, please see the following websites:
- Alzheimer’s Society:
- Alzheimer’s Research UK:
- Join Dementia Research – describes the different types of research into dementia that is taking place, and how to get involved
If you would like more in-depth information about drug treatments please watch the presentation by Prof Jon Schott in the video below.