Dementia – Can’t I just pop a pill?

There are currently two types of medications available for dementia.

The first are known as cholinesterase inhibitors ( eg Rivastigmine or Exelon) and they’re used to treat people with mild to moderate Alzheimer’s or Lewy Body Dementia. They work by reducing the breakdown of a chemical called acetyl choline which is important for learning and memory. In people with Alzheimer’s disease, the brain cells that produce acetyl choline start dying off so there isn’t enough of it in their brain. The drug increases levels of acetyl choline and it can slow down the progression of the disease in some people but it won’t reverse the damage that has already been done. Its effect seems to wear off after 3-5 years and it can take 3 months to start working. It comes in the form of capsules or a patch that you stick on the skin.

The second group of drugs are called N-methyl-D-aspartate (NMDA) receptor antagonists (eg Memantine or Ebixa) and they’re used in people with moderate to severe Alzheimer’s disease. These drugs block the action of a chemical called glutamate. People with Alzheimer’s have too much glutamate. This causes excessive amounts of calcium to enter their brain cells and damage them. The drugs help some people but only for a few years.

A person can take both drugs at the same time and they may benefit from the double treatment because the two medications work in completely different ways.

Recently there’s been optimism around a potential drug for a specific type of dementia called frontotemporal dementia or FTD. About 11 500 Australians have FTD and it tends to strike at a much younger age than Alzheimer’s. Symptoms can begin as early as 45 years (though usually the person is in their 50s or 60s) and 10-15% of cases are due to a gene mutation that can be passed on from one generation to the next. The good news is that the University of Melbourne is starting a trial in which patients will be given sodium selenate tablets for 12 months and tested for improvements in brain function.

If you’ve picked up on the word selenate – a form of selenium – and know that Brazil nuts are a rich source of selenium, it doesn’t mean licence to start hoeing through packets of Brazil nuts because getting the dose right is critical. Three Brazil nuts a day is plenty. Too much selenium can be toxic.

As for supplements that may be helpful in people with dementia, I give my father vitamin D, omega-3 and curcumin (the active ingredient in turmeric). Research suggests they may improve cognition and there appears to be no harm in taking them.

This concludes my Dementia Series for now. I received a lot of emails about various aspects of dementia and I felt it was important to provide what answers were available. I hope you’ve found them helpful.


This article is part of a series on dementia.
Discover the rest of the series below:

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