Alzheimer's Disease

Medications Used to Control Dementia

Anti-Dementia

Donepezil (Aricept): start with 5 mg/day; increase to 10 mg after four weeks.
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 1.5 mg twice a day; increase by 1.5 mg twice daily every four weeks up to 6.0 mg twice a day. Take after meals.
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 (Pamelor): 25 - 75 mg/day. Be sure to have doctor check the patient's blood plasma levels.
Side effects: dry mouth; confusion; constipation; sedation; light headed

Paroxetine (Paxil): 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 headed

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 headed; confusion; dry mouth; sedation; constipation

Haloperidol (Haldol): 0.25 - 2 mg/day (po, IM, or IV). Gradually increase the dose
Side effects: Parkinson's Disease symptoms; sedation; falling; abnormal movements

Olanzepine (Zyprexa): 2.5 - 10 mg/day
Side effects: sedation; light headed; confusion; dry mouth; constipation

Quetiapine (Seroquel): 12.5 - 200 mg/day in two divided doses
Side effects: sedation; light headed

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

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

Divalproex sodium (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 about these medications:

Drug Information (Medline Plus)

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Last Reviewed: Sep 06, 2005

Douglas W. Scharre, MD
Associate Professor of Clinical Neurology
Memory Disorders Clinic
Department of Neurology
College of Medicine
The Ohio State University