Dementia is the term used to describe the symptoms of a large group of illnesses that cause a progressive decline in a person’s functioning.
It is a broad term to describe a loss of memory, intellect, rationality, social skills and what would be considered normal emotional reactions. Dementia causes significant impairment in a person’s day to day functioning.
Drugs to treat the cognitive symptoms of dementia
A number of drugs are currently available in Australia for use by people with dementia. These drugs fall into two categories, cholinergic treatments and Memantine.
Cholinergic treatments offer some relief from the symptoms of Alzheimer’s disease for some people for a limited time. Drugs known as acetylcholinesterase inhibitors work by blocking the actions of an enzyme called acetylcholinesterase which destroys an important neurotransmitter for memory called acetylcholine. Current cholinergic treatments are approved for use for people with mild to moderate Alzheimer’s disease. A number of the acetylcholinesterase inhibitors are available as subsidised medicines under the Australian Pharmaceutical Benefits Scheme.
People may receive these drugs at nominal cost if a physician or psychiatrist has found them to have a diagnosis of Alzheimer’s disease. They must show improvement on a commonly used test of mental function in the first six months of treatment in order to receive further supplies of subsidised medication.
Memantine targets a neurotransmitter called glutamate that is present in high levels when someone has Alzheimer’s disease. Memantine blocks glutamate and prevents too much calcium moving into the brain cells causing damage. It is the first in a new class of therapies and acts quite differently to the acetylcholinesterase inhibitors that are currently approved for treatment in Australia.
Memantine is currently approved for use for people with moderately-severe to severe Alzheimer’s disease. It is available at subsidised rates under the Pharmaceutical Benefits Schedule for those who meet the criteria for diagnosis and stage of disease.
How to get treatment
It is important that the person has a firm diagnosis of Alzheimer’s disease, not another form of dementia and to determine which stage the disease is in. A specialist, such as neurologist, psychogeriatrician, geriatrician or psychiatrist, will usually be involved in the prescription of these drugs.