Drugs for the treatment of dementia

1. Summary

NICE, the government body responsible for recommending which drugs should be available on the NHS, recommends four drugs for the treatment of Alzheimer's disease in the UK and one drug for the treatment of severe aggression and agitation in people with Alzheimer's disease. There are no licensed drug treatments for other forms of dementia.

None of these drugs offer a cure for Alzheimer's disease. Current drugs can improve symptoms, or temporarily slow down progression, in some people. There is some emerging, but still controversial, evidence that these drugs also affect the underlying disease process.

Alzheimer’s Society supports the NICE guidance. The Society now calls for health bodies to ensure that this guidance is followed and that people with Alzheimer's disease can access drug treatments.

The Society calls for all parties, including clinicians, drug companies and the Department of Health, to undertake regular reviews and monitoring of medications for people with dementia and for people with dementia and carers to be able to access detailed information about the side-effects and possible benefits of treatments. Going forward, increases in funding are needed to ensure the development of new treatments. 

2. What the Society calls for:

  • Effective monitoring. Currently, it is not possible to predict who will benefit from an anti-dementia drug. The evidence suggests that about half of all patients will benefit from a drug treatment. The key to efficient, effective treatment is effective monitoring. Health and social care professionals should conduct regular reviews and monitoring of people with dementia who are prescribed medication and continue treatment for people with dementia who show evidence of benefit.
  • Implementation of NICE guidance. NICE, the government body responsible for assessing the cost and clinical effectiveness of drug treatments, recommends that the anticholinesterase drugs (Aricept, Exelon and Reminyl) should be available for people with dementia in the mild to moderate stages of Alzheimer's disease; Ebixa should be available for people with dementia who are unable to tolerate the anticholinesterase drugs in the moderate stage; and Ebixa should be available for all people with dementia in the severe stage.  Alzheimer's Society supports NICE's guidance. The Society campaigned for several years to get better access to drug treatments for people with Alzheimer's disease after previous NICE guidance restricted access. Health bodies must ensure that this guidance is followed and that people with Alzheimer's disease can access drug treatments.
  • Follow GMC and NICE-SCIE protocols on anti-psychotic drugs. Risperidone, which is an antipsychotic drug, is licensed for the treatment of severe aggression in people with dementia. For more information on the use of antipsychotic, please see our position statement on antipsychotic drugs. 
  • Information about side-effects and possible benefits. People with dementia and carers need detailed information about the relative side-effects and possible benefits of any drug that receives a licence. The use of such drugs should also be closely monitored by clinicians, drug companies and the Department of Health to ensure that patient safety remains paramount.
  • Involve people with dementia and carers in decision-making. People with dementia and carers must be consulted to ensure that they are involved in decision-making and have the information that they need to make an informed decision. People can refuse any drug treatment if they have the capacity to understand the impact of that decision. If someone lacks capacity, a carer, relative, friend or advocate should be involved as far as possible. Professionals must have reference to the Mental Capacity Act (2005).
  • Develop new treatments and potential cures to improve the care for people with dementia. There is a high level of unmet need among people with dementia and few treatments available. The UK needs a national and long-term plan for dementia research that it is funded in proportion to its impact on society and with greater co-ordination between funders of dementia research. For more information, please see our position statement on dementia research.