Newspapers are often full of headlines about dementia. Recently some of them have written articles about whether or not dementia drugs might cause heart problems.
What do we mean by 'dementia drugs'?
Dementia is the broad term used to describe a number of different conditions affecting the brain.
There is currently no cure for the diseases that cause dementia.
However, some drugs can help to relieve or control symptoms for people living with Alzheimer’s disease, dementia with Lewy bodies or Parkinson’s disease dementia.
Unfortunately, there are currently no drugs that can improve the cognitive symptoms of vascular dementia or frontotemporal dementia.
What drugs are available to treat the cognitive symptoms of dementia?
The main drugs used to treat cognitive symptoms of dementia are called ‘cholinesterase inhibitors’.
Cholinesterase inhibitors include donepezil, rivastigmine and galantamine. There is also a drug called memantine, which works slightly differently.
These drugs don’t work for everyone, and the average effect is fairly small. But, for most people, they’re still well worth trying.
What are the common side effects of dementia drugs?
While many people can take dementia drugs without any problems, some may experience unpleasant side effects. The most common side effects include:
- nausea, vomiting, diarrhoea
- loss of appetite
- muscle pain
- sleep problems
- feeling tired
- itching or a rash
- dizziness or feeling faint
- agitation or aggression
If you experience any of these symptoms while you are taking drugs for dementia, you should contact your GP as soon as possible. Your GP may be able to offer an alternative treatment that is easier for you to take.
Dementia drugs and heart problems: what does the latest research say?
The effect of dementia drugs on the health of a person’s heart and blood vessels appears to be generally quite positive.
A recent review of studies found that people who took cholinesterase inhibitors had a 37 per cent lower risk of having a heart attack or stroke.
The research study found that these people were also less likely to die from a heart-related problem.
However, the review also found an increased risk of a relatively rare problem called ‘bradycardia’.
What is bradycardia?
Bradycardia is when the heart beats too slowly. This can prevent enough blood from being pumped up to the brain, leaving the person feeling dizzy and breathless. This increases the risk of falling and sustaining a hip fracture, which is a really serious problem for older people in particular.
Because of the risks of falling, doctors often recommend that people with a very slow heart beat have a pacemaker fitted. This keeps the heart beating fast and regular enough to get a good supply of blood to the brain.
These issues are why your doctor is likely to check whether you have a pre-existing heart problem before prescribing these drugs.
So, the good news is that bradycardia is generally quite rare. Even though dementia drugs may increase the risk of having a slow heartbeat, the overall chances of developing this problem are still very low.
By contrast, heart attacks and strokes are quite common in older people, and dementia drugs like donepezil seem to reduce the risk of these happening.
It is very important to discuss any side effects you may be experiencing with your GP – particularly if these include feeling dizzy or faint. Your GP will be able to check your heart beat and assess the potential risks and benefits of continuing with your current medication. Keep taking your medication in the meantime, unless advised by a clinician to stop.