What Caregivers Need to Know About Dementia Medication Side Effects
There is no cure for dementia, but there is dementia medication that can help individuals manage their symptoms and improve their quality of life.
Since dementia is a group of conditions that cause impairment in memory, communication, thinking and physical abilities, there are also many different types of dementia medication. Each medication is prescribed for a specific purpose and may be more helpful depending on the type of dementia someone has, such as Alzheimer’s disease.
When physicians find the right dementia medication combination and dose, the treatment can help alleviate symptoms, helping individuals maximize their abilities. Unfortunately, like all types of medication, dementia medication may also cause some side effects, such as digestive issues, pain, sleep problems, itchy rashes and mood issues. More specifically, medications for dementia care can cause:
- Loss of appetite
- Muscle pain or cramps
- Sleep problems, such as insomnia
- Itching or a rash
- Dizziness or feeling faint
- Agitation, aggression
- Increased frequency of bowel movements
While this list may seem long at first, it’s important to note that it’s a list of potential side effects, not a list of side effects that someone will experience. In most cases, side effects can be minimized or eliminated by adjusting medication types or dosage. In other cases, individuals are more than willing to put up with a little fatigue to reduce more disruptive dementia symptoms.
In this article, we’ll go into more detailed information on the most common dementia medications and their side effects, including what caregivers need to know as they work with individuals and their physicians to find the right treatment regimen.
Major Types of Dementia Medications and their Side Effects
Cholinesterase Inhibitors (AChE Inhibitors)
People with Alzheimer’s disease have low levels of acetylcholine in their brains. Acetylcholine is a neurotransmitter, which is a type of chemical messenger that passes messages between nervous system cells and muscles. The most common type of dementia, Alzheimer’s disease, damages the cells that produce acetylcholine. This damage interferes with the messaging system between nerve cells in the brain, known as neurons, and the muscles.
People with dementia also tend to have high levels of acetylcholinesterase (AChE) in their brains. AChE is a type of enzyme that breaks down acetylcholine, so high levels of acetylcholinesterase cause even more widespread damage to the messaging system between the neurons and the rest of the body.
To help keep acetylcholine levels high, doctors prescribe cholinesterase inhibitors, also known as AChE inhibitors. As their name suggests, AChE inhibitors inhibit the acetylcholine-destroying action of the AChE enzyme. In other words, they increase healthy acetylcholine and brain function by suppressing neuron-damaging cholinesterase.
AChE inhibitors can help with symptoms related to thought processes, such as memory, language and judgment. Doctors typically prescribe AChE inhibitors for patients experiencing mild to moderate symptoms of dementia.
AChE inhibitors include:
- Donepezil (Aricept)
- Galantamine (Razadyne)
- Rivastigmine (Exelon)
Donepezil Side Effects
Along with their needed beneficial effects, AChE inhibitors can cause side effects. The most common side effects of donepezil include:
- Loss of appetite
- Muscle cramps
- Trouble sleeping
- Unusual tiredness or weakness
Galantamine Side Effects
Commonly reported side effects of galantamine include nausea and vomiting. Less commonly, galantamine causes:
- Chest pain or discomfort
- Lightheadedness, dizziness or fainting
- Shakiness in the legs, arms, hands or feet
- Shortness of breath
- Slow or irregular heartbeat
- Unusual tiredness
Rivastigmine Side Effects
Rivastigmine may cause a number of side effects, including:
- Abdominal pain
- Nausea and vomiting
- Weight loss
What Caregivers Should Watch For
The above side effects are some of the most common, but they’re not exhaustive lists. If you’re supporting someone taking any of these medications, make sure to pay attention to how their behavior and symptoms change when they begin taking the medication. Make notes of any changes, as well as how often they happen, so you can share them with your physician. Your physician may be able to use your notes to fine-tune the dementia medication regimen to reduce side effects while increasing the positive cognitive benefits of the AChE inhibitors.
Memantine works differently from AChE inhibitors in that it suppresses the production of a different chemical in the body, known as glutamate. However, glutamate is similar to acetylcholine – it too is a neurotransmitter that helps pass messages between nerve cells in the brain. Scientists consider glutamate to be the most important neurotransmitter in the brain. Under normal conditions, glutamate plays an important role in memory and learning.
Glutamate is a powerful “excitatory” neurotransmitter, which means it speeds up the communication between neurons. Having high levels of glutamate is not necessarily a good thing, though. Excess glutamate can excite the nerve cells too much and this over-excitation causes abnormal activity in the brain, making it harder to think and remember. This over-excitation can also damage the neurons, preventing the brain from working correctly.
To make matters worse, damaged nerve cells often produce glutamate to excite the neurons even more. This is important because dementia can damage neurons in ways that cause the nerve cells to produce even more glutamate.
To slow the damage to neurons and decrease abnormal activity in the brains of patients with dementia, doctors can prescribe memantine. Memantine may improve the ability to think and remember. It may also slow the loss of cognitive abilities in people with Alzheimer’s disease and other types of dementia.
As with all medications, including Alzheimer’s medication, memantine may cause side effects. The most common side effects of memantine include:
- Nausea, vomiting
- Weight gain
- Pain anywhere in the body, but especially in the back
What Caregivers Should Watch For
Caregivers should notify the doctor if the symptoms of these Alzheimer’s medication side effects are severe or do not go away. Some side effects can be serious. Seek medical attention right away if the patient experiences shortness of breath or hallucinations, as these may be signs of a serious adverse reaction.
The Risk of Side Effects
Every drug has side effects, but the many benefits of dementia medication greatly outweigh the risk of side effects in most cases. The risk of developing side effects depends on a number of factors, which can be patient-related, drug-related or related to social or environmental factors.
- Age is the most significant factor, with the very old most susceptible to adverse effects from medication.
- Other factors related to the individual, such as genetics, kidney function and gender also play a role.
- Drug-related factors, such as dose, the formula being used, the absorption and metabolism of drugs and even interactions with other medications can increase or decrease the risk of side effects.
- Environmental or social factors affecting the risk of side effects include the amount of alcohol a patient consumes, smoking, diet and hydration.
A caregiver’s level of understanding of the drug can affect the risk of side effects, as adverse reactions are more likely if the instructions are unclear or if there is confusion over why or how the medication should be taken.
Professional Help with Dementia Care and Medication Management
There are far more forms of dementia medication than those discussed above. Antidepressants may be used for individuals who are dealing with mental concerns, while other medication may help individuals manage muscle stiffness or spasms.
With so many different potential treatment regiments, handling dementia medication and its side effects can be difficult. But caregivers don’t need to handle it alone. When dementia care and medication management become too much, there are comfortable memory care communities that can provide full-time support along with medication management.
The skilled team at Heritage of Sandy Plains is devoted to providing tailored support through personal care and memory care programs. Since every individual is unique, Heritage of Sandy Plains develops tailored care plans to help residents manage medications, engage in fulfilling daily activities and stimulate their minds, so they can live a full life regardless of their physical or mental challenges. We will work with you, our residents and physicians to ensure that all dementia medication and care is handled correctly.