In Australia, the key dementia drugs approved by the TGA are donanemab (Kisunla) and lecanemab (Leqembi), which slow Alzheimer's progression by removing amyloid plaques, while older medications like donepezil, galantamine, and rivastigmine manage symptoms. These disease-modifying treatments are significant breakthroughs, but currently only available privately as they aren't yet on the Pharmaceutical Benefits Scheme (PBS).
Cholinesterase Inhibitors are the most commonly prescribed medications for dementia. There are 3 cholinisterase inhibitors, which include, Donepezil, Galantamine and Rivastigmine. Important to note: There are no significant differences in effectiveness between the three drugs.
How this fits in. Current National Institute for Health and Care Excellence (NICE) guidance allows GPs to prescribe memantine for moderate-to-severe Alzheimer's disease (AD) in patients already taking an acetylcholinesterase inhibitor (AChEI) without referral to secondary care.
Side effects of memantine
Headaches. Dizziness or problems with balance. Tiredness or shortness of breath. Raised blood pressure.
Cholinesterase inhibitors and memantine are covered under Medicare Part D. But each Medicare Part D plan is only required to cover at least two drugs in each category. Since there are more than two cholinesterase inhibitors, it's important to check the plan details to see if a specific medication is covered.
Donanemab, like lecanemab, is a type of drug called a monoclonal antibody. Antibodies form part of our immune system and bind to harmful proteins to destroy them. Donanemab contains antibodies that bind to a protein called amyloid, which builds up in the brain in the early stages of Alzheimer's disease.
Memantine is used to treat people in the middle and later stages of Alzheimer's disease or dementia with Lewy bodies. It can help with worsening mental abilities, such as confusion or feeling lost, and problems carrying out daily activities, such as getting dressed.
Alzheimer disease is the most common form of dementia and may contribute to 60–70% of cases. Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency among older people globally.
A large study found that older adults who took vitamin D had a 40% lower chance of developing dementia than those who didn't. You can get vitamin D from food like fish, eggs, and vitamin D-fortified milk.
Memantine is not suitable for some people. To make sure it's safe, tell your doctor if you, or the person you're caring for, have: ever had an allergic reaction to memantine or any other medicine. epilepsy or have ever had a seizure or fit.
When someone gets the diagnosis of dementia, a cure is only very rarely possible (see p2 About Reversible Dementias). In the current issue of Neurology, Sacks and Shulman1 report one of these rare cases of a reversal of dementia involving a patient on steroid medication.
Smoking, low physical activity, and a poor diet are all lifestyle and environmental influences that have been linked to rapid dementia decline. Physical activity promotes cardiovascular health, which in turn improves brain function. Those who lead a sedentary lifestyle may experience faster cognitive decline.
Seroquel is the brand name for quetiapine, an atypical antipsychotic that is used off-label to treat severe behavioral signs of dementia. It can help with bad symptoms, including agitation, aggressiveness, and hallucinations, that other drugs don't help with.
According to the most recent (2018) NICE guidance,13 prescription for memantine may be initiated by a GP for a patient with moderate- to- severe AD, if the patient is already taking an AChEI,13 without referral back to secondary care.
Top Medicare Part D Plans for Seniors
Coverage details
Medicare covers FDA-approved monoclonal antibodies (like Leqembi, generic name lecanemab) that target beta-amyloid plaques for the treatment of Alzheimer's disease.