Alzheimer's Disease is a degenerative disease of the brain that eventually leads to dementia and death. At the current time, there is no cure for Alzheimer's, and the treatments that are available for the disease do little more than try to delay the severity of the disease. A person with Alzheimer's Disease is typically at least 65 years old (but they can be younger) and they are diagnosed by a specialist (no biomarkers currently exist). These patients show a marked decline in memory, judgment, ability to communicate and other primary cognitive functions.
In some patients with Alzheimer's Disease, depression, anxiety, agitation, delusions, and hallucinations can develop in the early stages, making life even more difficult. To control some of these problems, doctors can use some antidepressants, anti-anxiety medications, and antipsychotics.
There are no specific drugs that have been approved by the US Food and Drug Administration for the treatment of anxiety in Alzheimer's patients, but that isn't to say there aren't other approved drugs that can help reduce the symptoms.
Anxiety in Alzheimer's patients may not manifest itself the way that it does in other settings. For example, Alzheimer's patients may manifest anxiety merely by choosing to withdraw from social functions or from doing things they once enjoyed. They may have outbursts of anger toward loved ones or caregivers. Or they may show the classic signs of anxiety—sweating, worrying, rapid heartbeat.
Most clinicians recommend strategies other than medications to control anxiety in Alzheimer's patients first, and only resorting to drugs if behavioral strategies fail to control the anxiety.
In those cases, short-term anti-anxiety drugs such as lorazepam (marketed as Ativan) may be useful, but there are inherent problems associated with these powerful sedatives, such as a reduced ability to remain steady and general cognitive cloudiness or confused state that only adds to the problem.
In some cases, selective serotonin reuptake inhibitors such as Prozac or Zoloft have been used. These drugs can treat both depression and anxiety, but they would like Ativan, be prescribed off-label and there is not a lot of data supporting their prolonged use.
Finally, there are the known FDA approved drugs for Alzheimer's patients. These drugs are in a class called cholinesterase inhibitors. They work by improving the function of nerve cells in the brain by blocking the chemical breakdown of acetylcholine, which is a crucial chemical in the brain involved in memory and reasoning.
The drugs—Aricept, Exelon, and Razadyne—could contribute to decreased anxiety in Alzheimer's patients by reducing the symptoms of the disease itself. In other words, they could reduce anxiety and depression as an indirect effect.
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