Dementia Drugs: What Works, What Doesn’t, and What to Ask Your Doctor

When someone you care about starts showing signs of memory loss, the search for help often leads to dementia drugs, medications approved to slow cognitive decline in conditions like Alzheimer’s disease. Also known as cognitive enhancers, these aren’t cures—but for many, they can make a real difference in daily life. The most common ones fall into two groups: cholinesterase inhibitors and memantine. Cholinesterase inhibitors—like donepezil, rivastigmine, and galantamine—work by boosting acetylcholine, a brain chemical that’s low in Alzheimer’s patients. Memantine, on the other hand, blocks excess glutamate, a neurotransmitter that can damage brain cells when overactive. These aren’t interchangeable. Doctors often start with one, then add the other if symptoms progress.

What most people don’t realize is that cholinesterase inhibitors, a class of drugs used to treat mild to moderate Alzheimer’s symptoms don’t work the same for everyone. Some see sharper focus for months; others notice little change. Side effects like nausea, diarrhea, or dizziness can be tough to manage, especially in older adults. That’s why many patients switch or stop. And while memantine, a medication approved for moderate to severe Alzheimer’s that helps regulate brain signaling is generally better tolerated, it’s not magic. It doesn’t bring back lost memories—it just slows the pace of decline. What’s missing from most conversations? The fact that these drugs are often used alongside non-drug approaches: physical activity, structured routines, and social engagement. Studies show combining meds with lifestyle changes gives better results than meds alone.

There’s no single best dementia drug. The right choice depends on the stage of disease, other health conditions, and how the person responds. Some families wonder about supplements or off-label options, but most of those lack strong evidence. What you’ll find in the posts below are real comparisons—like how donepezil stacks up against rivastigmine, why memantine is sometimes paired with it, and what alternatives doctors consider when standard drugs fail. You’ll also see how side effects like dizziness or confusion can overlap with other meds, like those for blood pressure or anxiety. This isn’t theoretical. These are the trade-offs people face every day. If you’re trying to make sense of a treatment plan, these posts give you the facts without the jargon.