What to Know About Discontinuing Alzheimer's Drugs

If you're the main caregiver for your loved one, you want to provide the best care possible for them. That includes considering which medications they are receiving and whether these drugs should be continued or discontinued.

Assorted pills on a table
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Of course, these decisions are made in partnership with a physician, but after the doctor provides the rationale for their recommendations, they will probably ask you for your opinion. So, what to do? First, acknowledge that this can be a stressful decision to make. And second, learn all you can about what research has demonstrated about this decision.

Benefits of Medications

Medications are prescribed for people with dementia with the hope of slowing down the progression or even improving the cognitive functioning for a time. Research has shown that there is often some benefit from these medications, although they don't cure the disease.

Treating Alzheimer's Disease

There are three types of medications prescribed to treat Alzheimer's disease.

Cholinesterase Inhibitors

  • Aricept (donepezil): Approved for mild, moderate, and severe Alzheimer's
  • Adlarity (donepezil transdermal patch): Approved for mild, moderate, and severe Alzheimer's
  • Exelon (rivastigmine): Approved for mild to moderate Alzheimer's
  • Razadyne (galantamine): Approved for mild to moderate Alzheimer's

N-Methyl D-Aspartate (NMDA) Antagonists

  • Namenda (memantine) is another medication that is used to try to slow down the progression of dementia and is approved for use in moderate to severe Alzheimer's disease.

Amyloid Beta-Directed Antibody

  • Leqembi (lecanemab) is FDA-approved for the treatment of Alzheimer's disease in individuals with mild cognitive impairment or dementia who have confirmed amyloid beta plaques.
  • Aduhelm (aducanumab) is directed at reducing amyloid beta plaques in the brain—the underlying cause of the disease.

In January 2024, Biogen, the maker of Aduhelm, announced that it would discontinue sales and clinical trials for the drug by November 2024. The FDA approved Aduhelm for the treatment of mild cognitive impairment or early Alzheimer's disease. However, studies showed that Aduhelm had no or only a slight benefit in slowing cognitive decline.

Why Discontinue Medications

Consider discontinuing medications when one or both of the following two factors arise:

  • Side Effects: If there are too many side effects or they diminish the quality of life for the person, strong consideration should be given towards discontinuing the medication.
  • No Benefit: If the person has been on the medication for quite some time and now her dementia has progressed to the late stages, physicians and pharmacists will sometimes recommend discontinuing the medication if there is no observed benefit. This decision may, at times, be made when a person elects hospice care, but at other times it is considered as an option simply if the perceived benefit is little or none.

How Medications Should Be Discontinued

Medications should be discontinued gradually and one at a time. When discontinuing medications, monitor your loved one closely. If you start to see a significant decline in cognition or behavior, you may want to ask the physician to restart the medication.

If a notable decline in functioning develops after discontinuation, restarting the medication sooner rather than later may increase the likelihood of the person returning close to his previous (prior to stopping the medicine) level of functioning.

What Research Has Shown

There has not been a lot of research conducted on stopping medications for the treatment of dementia. However, some research seems to indicate that people whose dementia medications were discontinued declined in cognition and behavior more quickly.

One study compared nursing home residents with dementia who were receiving cholinesterase inhibitor medications to treat dementia to other nursing home residents whose cholinesterase inhibitors were discontinued.

The researchers found that those whose medications were discontinued experienced more behavioral challenges such as repetitive questioning and frequent health concerns. This group also participated less in activities compared to those who were still on their medication.

Make an Educated Decision

There can be a range of results after medications for dementia have been discontinued. At times, there has been a decline in functioning as described above after discontinuing the medications, and there have also been other situations where there was very little change, if any, after medications for dementia were discontinued. The key is for family members to be aware that the possibility for decline exists and to make this decision together with their loved one's physician.

A Word From Verywell

One physician proposed the following question when considering whether or not to discontinue medication for the treatment of Alzheimer's disease:

"Is there anything going on in this life that is good and might be missed if the medication is stopped?" (Dr. Gene Lammers)

The decision to continue or stop medication in Alzheimer's disease should be one that is based on each individual's preferences and level of functioning. Perhaps considering the above question will be helpful to clarify your next steps as you seek your loved one's best interests.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.