Alzheimer's medication: a practical guide

Only a handful of drugs are proven to help with Alzheimer’s symptoms — they don’t cure the disease, but they can slow decline or ease behavior for months or years. If you or a loved one is facing a diagnosis, knowing what each medicine does and what to watch for makes decisions easier. This guide cuts to the useful parts: names, effects, side effects, safety tips, and real-world money and buying advice.

How the main drugs work

There are two groups of drugs you’ll hear about most. Cholinesterase inhibitors include donepezil (Aricept), rivastigmine, and galantamine. They boost a brain chemical called acetylcholine and can help memory and thinking in mild to moderate Alzheimer’s. Effects are usually modest — some people show clear benefit for months to a couple of years.

Memantine (Namenda) works differently and is used for moderate to severe Alzheimer’s. It helps regulate glutamate activity and can improve daily function and reduce agitation for some patients. Doctors sometimes combine memantine with a cholinesterase inhibitor for added benefit when symptoms progress.

Side effects and safety — what to watch for

Common side effects are nausea, diarrhea, sleep changes, and muscle cramps with cholinesterase inhibitors. Donepezil can slow heart rate, so if the person has fainting or heart issues, tell the doctor. Memantine can cause dizziness and headaches. Older adults can be more sensitive — watch for dehydration, low sodium, and falls. If you notice sudden confusion, fainting, or new breathing trouble, seek medical help.

Drug interactions matter. Avoid combining strong anticholinergic drugs (some allergy or bladder meds) with cholinesterase inhibitors — they work against each other. Be careful with sedatives or benzodiazepines; they can worsen confusion and fall risk. Always share a complete medication list with the prescriber and pharmacist.

Practical tips for caregivers and cost savings

Start low and go slow — doses are often increased gradually to reduce side effects. Keep a simple daily pill chart or use a pill box. Track appetite, sleep, bathroom habits, and falls; these clues tell you if a medicine is helping or causing harm. Non-drug supports matter: routine, simple cues, activity, and safe home changes often reduce agitation and help memory.

Medications can be expensive, but there are ways to save. Ask about generic options, prescription discount services, and pharmacy price comparisons. If buying from an online pharmacy, check for a valid license, clear contact info, and require a prescription. Be cautious of sites that ship without a prescription or come from unknown countries — customs rules and safety vary.

Always talk with the doctor about goals of treatment: improve daily life, reduce symptoms, or manage behavior. If a drug isn’t helping after a reasonable trial, ask about stopping or switching. Clear, simple monitoring and open communication with the care team make treatment safer and more likely to help.