Medications Used to Control Dementia
Anti-Dementia
Donepezil (Aricept®): Start with 5 mg/day; increase to 10 mg after four weeks and then to 23 mg after 3 months.
Side effects: nausea; diarrhea; poor appetite
Galantamine (Razadyne®ER): Start with 8 mg a day; increase by 8 mg every four weeks up to 24 mg a day.
Side effects: nausea; diarrhea; poor appetite
Memantine (Namenda®): Start with 5 mg a day; increase by 5 mg a week up to 10 mg twice a day.
Side effects: headache, dizziness, confusion
Rivastigmine Exelon®): Start with 4.6 mg/24 hour patch daily; increase to 9.5 mg/24 hour patch daily in 4 weeks.
Side effects: nausea; diarrhea; poor appetite
Antidepressants
Bupropion Wellbutrin® ): 75 – 300 SR mg/day in two divided doses or 150 ? 300 XL mg once a day.
Side effects: agitation; anxiety; seizures; restlessness; insomnia; arrhythmia
Citalopram (Celexa®): 10 – 60 mg/day
Side effects: nausea; dry mouth; sedation
Clomipramine (Anafranil®): 50 ? 250 mg/day in two divided doses
Side effects: sedation; seizures; weight gain; sexual dysfunction
Escitalopram (Lexapro®): 10 ? 20 mg/day
Side effects: nausea, dry mouth; sedation
Fluoxetine (Prozac®): 10 – 40 mg/day
Side effects: anxiety; insomnia; nausea; weight loss; tremor
Fluvoxamine (Luvox): 50 – 300 mg/day in two divided doses
Side effects: nausea; insomnia; sedation
Mirtazepine (Remeron®): 15 – 30 mg at night
Side effects: sedation; weight gain; dry mouth
Nortriptyline (Aventyl®): 25 – 75 mg/day. Be sure to have doctor check the patient’s blood plasma levels.
Side effects: dry mouth; confusion; constipation; sedation; light-headedness
Paroxetine (Paxil®): Start with 10 – 40 mg/day.
Side effects: insomnia; nausea; anxiety
Sertraline (Zoloft®): 50 – 200 mg/day
Side effects: insomnia; diarrhea; tremor
Trazodone (Deseryl): 50 – 300 mg at night
Side effects: sedation; light-headedness
Venlafaxine (Effexor®): 37.5 – 150 XR mg/day
Side effects: nausea; sedation
Antipsychotics
Aripiprazole (Abilify®): 5 to 15 mg/day
Side effects: activation; sedation
Clozapine (Clozaril®): 6.25 – 200 mg/day in one or two doses. Must get weekly white blood counts.
Side effects: severely low white blood count; light headedness; confusion; dry mouth; sedation; constipation
Haloperidol (Haldol®) : 0.25 – 2 mg/day. Gradually increase this dose. Use sparingly only for severe agitation.
Side effects: Parkinson’s Disease symptoms; sedation; falling; abnormal movements
Olanzepine (Zyprexa®): 2.5 – 10 mg/day
Side effects: sedation; light headedness; confusion; dry mouth; constipation
Quetiapine (Seroquel®): 12.5 – 200 mg/day in two divided doses
Side effects: sedation; light headedness
Risperidone (Risperdal®): 0.5 – 2 mg/day in two divided doses
Side effects: sedation; Parkinson’s Disease symptoms
Ziprasidone (Geodon®): 20 ? 160 mg/day in two divided doses
Side effects: irregular heart beat; sedation; Parkinson’s Disease symptoms
Stroke Prevention
Aspirin: 81 – 325 mg every day
Side effects: excessive bleeding; stomach irritation
Clopidogrel (Plavix®): 75 mg every day
Side effects: stomach irritation; rash; bleeding
Ticlopidine (Ticlid®): 250 mg twice a day. Blood tests required every two weeks for six weeks
Side effects: May cause a decrease in the number of neutrophils – a type of immune cell – in blood
Aspirin and extended-release dipyridamole (Aggrenox®): one capsule twice a day.
Side effects: Stomach irritation; bleeding; rash; flushing; dizziness; chest pain
Miscellaneous
Buspirone (BuSpar®): 10 – 60 mg/day in divided doses
Side effects: dizziness; nausea; headache
Carbamazepine (Tegretol®): 200 ? 800 mg/day in three divided doses
Side effects: confusion, imbalanced gait; nausea; low white blood counts
Cimetidine (Tagamet®): 100 ? 300 mg four times a day
Side effects: headaches; diarrhea
Valproic Acid (Depakote®): 125 – 1500 mg/day in three divided doses or 250 ? 1500 ER mg once a day
Side effects: nausea; sedation; liver toxicity (rare); inflammation of the pancreas
Gabapentin (Neurontin®): 100 ? 600 mg/day in two divided doses
Side effects: sedation; imbalanced gait; confusion
Lamotrigine (Lamictal®): 50 ? 500 mg/day in two divided doses
Side effects: rash; liver or kidney failure; arthritis
Lorazepam (Ativan®): 0.5 – 2 mg every day in divided doses. Use sparingly only for severe agitation.
Side effects: confusion; sedation; uninhibited behavior; abnormal movements; anxiety if taking the drug is stopped
Melatonin: 1 ? 9 mg/day
Side effects: sleepiness
Propranolol (Inderal®): 40 – 320 mg/day
Side effects: slowed heart beat (less than 60 beats/minute); low blood pressure
Zolpidem (Ambien®): 5 – 10 mg at night.
Side effects: daytime drowsiness; dizziness; headache
For more information:
Go to the Alzheimer’s Disease health topic.