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Alzheimer's Disease

Medications Used to Control Dementia

Anti-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

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Last Reviewed: Apr 06, 2011


Clinical Associate Professor of Neurology
Clinical Associate Professor of Psychiatry
College of Medicine
The Ohio State University