Are Alzheimer's disease drugs effective for other types of dementia?

We explore the evidence behind the effectiveness of Alzheimer's disease drugs as treatment for people that are living with other types of dementia.

What does the research say?

The cholinesterase inhibitors were developed to treat Alzheimerā€™s disease.

There has not been as much research into whether they (or memantine) are helpful for people with other types of dementia.

Drugs for dementia with Lewy bodies and Parkinson's disease dementia

There is now good evidence that donepezil and rivastigmine are effective and safe in people with dementia with Lewy bodies (DLB) and dementia due to Parkinsonā€™s disease, a closely related condition. This is to be expected because acetylcholine levels are often even lower in people with DLB or Parkinsonā€™s disease dementia than in those with Alzheimerā€™s disease.

A person in the early or middle stage of DLB or Parkinsonā€™s disease dementia who takes donepezil or rivastigmine may find that it helps with:

  • mental abilities such as memory, attention and alertness
  • motivation
  • delusions and hallucinations
  • daily activities.

There is very little evidence about whether galantamine helps or not in either DLB or Parkinsonā€™s disease dementia. Galantamine should only be prescribed if neither donepezil nor rivastigmine can be taken.

Rivastigmine is licensed for Parkinsonā€™s disease dementia but none of these drugs are licensed for DLB. So prescription of a cholinesterase inhibitor (or memantine) for a person with DLB will be outside the terms of the drug licence (ā€˜off labelā€™). The drugs are safe but the doctor should mention this when the person starts the treatment.

There is not enough evidence yet to show clearly that memantine is helpful for people with DLB and Parkinsonā€™s disease dementia. Memantine may be prescribed if the person cannot take a cholinesterase inhibitor.

For more information, see What is dementia with Lewy bodies (DLB)? and Rarer types of dementia.

Summary of NICE guidance

National Institute for Care and Health Excellence (NICE) issued guidance regarding access to drugs.

Learn more

Drugs for vascular dementia

There has been research on treating vascular dementia with the drugs used for Alzheimerā€™s disease. This has shown that these drugs donā€™t have much of an effect. Where they bring a benefit, this is small and is usually seen for mental abilities of people who have both Alzheimerā€™s disease and vascular dementia (the most common type of mixed dementia). NICE guidelines recommend cholinesterase inhibitors for treatment of mixed dementia when Alzheimerā€™s disease is one of the causes, but not for the treatment of just vascular dementia. For more information see What is vascular dementia?

Drugs for frontotemporal dementia

There is no good evidence that the cholinesterase inhibitors or memantine help people with FTD, including Pickā€™s disease. In some people they may make symptoms worse.

These drugs are not licensed for FTD and will not usually be prescribed for it. For more information see What is frontotemporal dementia (FTD)?

Drug Discovery programme

Learn about an exciting new approach to developing treatments for dementia by 'repurposing' existing drugs.

Find out more
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