FDA-approved treatments for Alzheimer’s

Drugs that may delay clinical decline Drugs in this category may delay clinical decline with benefits to both cognition and function in people living with Alzheimer’s disease: Aducanumab (Aduhelm™): anti-amyloid antibody intravenous (IV) infusion therapy approved for Alzheimer's disease. An FDA-approved diagnostic test is required; talk with your doctor about options. Aduhelm works by targeting beta-amyloid, a microscopic protein fragment that forms in the brain and accumulates into plaques. These plaques disrupt communication between nerve cells in the brain and may also activate immune system cells that trigger inflammation and devour disabled nerve cells. While scientists aren’t sure what causes cell death and tissue loss during the course of Alzheimer’s disease, amyloid plaques are one of the potential contributors. Aduhelm is the first therapy to demonstrate that removing betaamyloid resulted in better clinical outcomes. Aduhelm was shown in clinical trials to delay the clinical decline of people living with early Alzheimer’s disease (mild cognitive impairment (MCI) due to Alzheimer's or mild Alzheimer's dementia).

The following medications are prescribed to treat symptoms related to memory and thinking: Cholinesterase inhibitors (Aricept®, Exelon®, Razadyne®) Cholinesterase (KOH-luh-NES-ter-ays) inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes. These medications prevent the breakdown of acetylcholine (a-SEAtil-KOHlean), a chemical messenger important for memory and learning. These drugs support communication between nerve cells. The cholinesterase inhibitors most commonly prescribed are:  Donepezil (Aricept®): approved to treat all stages of Alzheimer’s disease.
Rivastigmine (Exelon®): approved for mild-to-moderate Alzheimer’s as well as mild-to-moderate dementia associated with Parkinson’s disease. Galantamine (Razadyne®): approved for mild-to-moderate stages of Alzheimer’s disease.
Though generally well-tolerated, if side effects occur, they commonly include nausea, vomiting, loss of appetite and increased frequency of bowel movements. Glutamate regulators (Namenda®) Glutamate regulators are prescribed to improve memory, attention, reason, language and the ability to perform simple tasks. This type of drug works by regulating the activity of glutamate, a different chemical messenger that helps the brain process information. This drug is known as: Memantine (Namenda®): approved for moderate-to-severe Alzheimer’s disease. Can cause side effects, including headache, constipation, confusion and dizziness. Cholinesterase inhibitor + glutamate regulator (Namzeric®) This type of drug is a combination of a cholinesterase inhibitor and a glutamate regulator. Donepezil and memantine (Namzaric®): approved for moderate-tosevere Alzheimer’s disease. Possible side effects include nausea, vomiting, loss of appetite, increased frequency of bowel movements, headache, constipation, confusion and dizziness.
At this time, the FDA has approved one drug to address insomnia in people living with dementia, but trials into drugs that address other non-cognitive symptoms are underway. Orexin receptor antagonist (Belsomra®) Prescribed to treat insomnia for individuals living with dementia, this drug is thought to inhibit the activity of orexin, a type of neurotransmitter involved in the sleep-wake cycle: Suvorexant (Belsomra®): approved for mild-to-moderate Alzheimer’s disease. Possible side effects include, but are not limited to: risk of impaired alertness and motor coordination (including impaired driving), worsening of depression or suicidal thinking, complex sleep behaviors (such as sleep-walking and sleep-driving), sleep paralysis and compromised respiratory function.

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