Table of ContentsView AllTable of ContentsBenefits of MedicationsTreating Alzheimer’s DiseaseWhy Discontinue MedicationsHow Medications Should Be DiscontinuedWhat Research Has ShownMake an Educated Decision
Table of ContentsView All
View All
Table of Contents
Benefits of Medications
Treating Alzheimer’s Disease
Why Discontinue Medications
How Medications Should Be Discontinued
What Research Has Shown
Make an Educated Decision
If you’re the maincaregiverfor your loved one, you want to provide the best care possible for them. That includes considering whichmedicationsthey are receiving and whether these drugs should be continued or discontinued.
yolanda pons / FOAP / Getty Images
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.
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.
There are three types of medications prescribed to treat Alzheimer’s disease.
Cholinesterase Inhibitors
N-Methyl D-Aspartate (NMDA) Antagonists
Amyloid Beta-Directed Antibody
Consider discontinuing medicationswhen one or both of the following two factors arise:
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.
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 comparednursing homeresidents 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 morebehavioral challengessuch as repetitive questioning and frequent health concerns. This group also participated less inactivitiescompared to those who were still on their medication.
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.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Atri A.Current and future treatments in Alzheimer’s disease.Semin Neurol. 2019;39(2):227-40. doi:10.1055/s-0039-1678581Casey DA, Antimisiaris D, O’Brien J.Drugs for Alzheimer’s disease: Are they effective?.P T. 2010;35(4):208–211.Sharma K.Cholinesterase inhibitors as Alzheimer’s therapeutics (Review).Mol Med Rep. 2019;20(2):1479–87. doi:10.3892/mmr.2019.10374Knowles J.Donepezil in Alzheimer’s disease: An evidence-based review of its impact on clinical and economic outcomes.Core Evid. 2006;1(3):195–219.Corium.Corium receives FDA approval of Adlarity® (donepeziltransdermal system) for treatment of patients with Alzheimer’s disease.Khoury R, Rajamanickam J, Grossberg GT.An update on the safety of current therapies for Alzheimer’s disease: Focus on rivastigmine.Ther Adv Drug Saf. 2018;9(3):171-8. doi:10.1177/2042098617750555Hager K, Baseman AS, Nye JS, et al.Effects of galantamine in a 2-year, randomized, placebo-controlled study in Alzheimer’s disease [published correction appears in Neuropsychiatr Dis Treat. 2014;10:1997].Neuropsychiatr Dis Treat. 2014;10:391–401. doi:10.2147/NDT.S57909Olivares D, Deshpande VK, Shi Y, et al.N-methyl D-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer’s disease, vascular dementia and Parkinson’s disease.Curr Alzheimer Res. 2012;9(6):746–758. doi:10.2174/156720512801322564Kuns B, Rosani A, Patel P, Varghese D.Memantine. In:StatPearls. StatPearls Publishing; 2024.Soler A, Amer G, Leiva A, et al.Continuation versus discontinuation of treatment for severe dementia: Randomized, pragmatic, open-label, clinical trial to evaluate the efficacy of continuing drug treatment in patients with severe dementia (STOP-DEM).BMC Geriatr. 2019;19(1):101. doi:10.1186/s12877-019-1122-2Massoud F, Gauthier S.Update on the pharmacological treatment of Alzheimer’s disease.Curr Neuropharmacol. 2010;8(1):69–80. doi:10.2174/157015910790909520Lim EY, Yang DW, Kim JS, Cho AH.Safety and efficacy of anti-dementia agents in the extremely elderly patients with dementia.J Korean Med Sci. 2018;33(19):e133. doi:10.3346/jkms.2018.33.e133Daiello LA, Ott BR, Lapane KL, Reinert SE, Machan JT, Dore DD.Effect of discontinuing cholinesterase inhibitor therapy on behavioral and mood symptoms in nursing home patients with dementia.Am J Geriatr Pharmacother. 2009;7(2):74-83. doi:10.1016/j.amjopharm.2009.04.002Saint-Paul LP, Martin J, Gaillard C, et al. [Sudden discontinuation of anti-dementia drugs in moderate and severe Alzheimer’s disease in a residency for dependent elderly people: a longitudinal descriptive pilot study].Therapies. 2015;70(4):313-9. doi:10.2515/therapie/2014217Additional ReadingBrodaty H.Ask the experts: When do you stop a cholinesterase inhibitor in Alzheimer’s disease?Neurodegener Dis Manag. 2011;1(3):191-2. doi:10.2217/nmt.11.30Howard R, McShane R, Lindesay J, et al.Donepezil and memantine for moderate-to-severe Alzheimer’s disease.N Engl J Med. 2012;366(10):893-903. doi:10.1056/NEJMoa1106668Lee, PE, Hsiung GYR, Seitz D, Gill SS, Rochon PA.Cholinesterase inhibitors.BCMG. 2011;53(8):404-8.Winslow BT, Onysoko MK, Stob CM, Hazlewood KA.Treatment of Alzheimer disease.Am Fam Physician. 2011;83(12):1403-12.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Atri A.Current and future treatments in Alzheimer’s disease.Semin Neurol. 2019;39(2):227-40. doi:10.1055/s-0039-1678581Casey DA, Antimisiaris D, O’Brien J.Drugs for Alzheimer’s disease: Are they effective?.P T. 2010;35(4):208–211.Sharma K.Cholinesterase inhibitors as Alzheimer’s therapeutics (Review).Mol Med Rep. 2019;20(2):1479–87. doi:10.3892/mmr.2019.10374Knowles J.Donepezil in Alzheimer’s disease: An evidence-based review of its impact on clinical and economic outcomes.Core Evid. 2006;1(3):195–219.Corium.Corium receives FDA approval of Adlarity® (donepeziltransdermal system) for treatment of patients with Alzheimer’s disease.Khoury R, Rajamanickam J, Grossberg GT.An update on the safety of current therapies for Alzheimer’s disease: Focus on rivastigmine.Ther Adv Drug Saf. 2018;9(3):171-8. doi:10.1177/2042098617750555Hager K, Baseman AS, Nye JS, et al.Effects of galantamine in a 2-year, randomized, placebo-controlled study in Alzheimer’s disease [published correction appears in Neuropsychiatr Dis Treat. 2014;10:1997].Neuropsychiatr Dis Treat. 2014;10:391–401. doi:10.2147/NDT.S57909Olivares D, Deshpande VK, Shi Y, et al.N-methyl D-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer’s disease, vascular dementia and Parkinson’s disease.Curr Alzheimer Res. 2012;9(6):746–758. doi:10.2174/156720512801322564Kuns B, Rosani A, Patel P, Varghese D.Memantine. In:StatPearls. StatPearls Publishing; 2024.Soler A, Amer G, Leiva A, et al.Continuation versus discontinuation of treatment for severe dementia: Randomized, pragmatic, open-label, clinical trial to evaluate the efficacy of continuing drug treatment in patients with severe dementia (STOP-DEM).BMC Geriatr. 2019;19(1):101. doi:10.1186/s12877-019-1122-2Massoud F, Gauthier S.Update on the pharmacological treatment of Alzheimer’s disease.Curr Neuropharmacol. 2010;8(1):69–80. doi:10.2174/157015910790909520Lim EY, Yang DW, Kim JS, Cho AH.Safety and efficacy of anti-dementia agents in the extremely elderly patients with dementia.J Korean Med Sci. 2018;33(19):e133. doi:10.3346/jkms.2018.33.e133Daiello LA, Ott BR, Lapane KL, Reinert SE, Machan JT, Dore DD.Effect of discontinuing cholinesterase inhibitor therapy on behavioral and mood symptoms in nursing home patients with dementia.Am J Geriatr Pharmacother. 2009;7(2):74-83. doi:10.1016/j.amjopharm.2009.04.002Saint-Paul LP, Martin J, Gaillard C, et al. [Sudden discontinuation of anti-dementia drugs in moderate and severe Alzheimer’s disease in a residency for dependent elderly people: a longitudinal descriptive pilot study].Therapies. 2015;70(4):313-9. doi:10.2515/therapie/2014217Additional ReadingBrodaty H.Ask the experts: When do you stop a cholinesterase inhibitor in Alzheimer’s disease?Neurodegener Dis Manag. 2011;1(3):191-2. doi:10.2217/nmt.11.30Howard R, McShane R, Lindesay J, et al.Donepezil and memantine for moderate-to-severe Alzheimer’s disease.N Engl J Med. 2012;366(10):893-903. doi:10.1056/NEJMoa1106668Lee, PE, Hsiung GYR, Seitz D, Gill SS, Rochon PA.Cholinesterase inhibitors.BCMG. 2011;53(8):404-8.Winslow BT, Onysoko MK, Stob CM, Hazlewood KA.Treatment of Alzheimer disease.Am Fam Physician. 2011;83(12):1403-12.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Atri A.Current and future treatments in Alzheimer’s disease.Semin Neurol. 2019;39(2):227-40. doi:10.1055/s-0039-1678581Casey DA, Antimisiaris D, O’Brien J.Drugs for Alzheimer’s disease: Are they effective?.P T. 2010;35(4):208–211.Sharma K.Cholinesterase inhibitors as Alzheimer’s therapeutics (Review).Mol Med Rep. 2019;20(2):1479–87. doi:10.3892/mmr.2019.10374Knowles J.Donepezil in Alzheimer’s disease: An evidence-based review of its impact on clinical and economic outcomes.Core Evid. 2006;1(3):195–219.Corium.Corium receives FDA approval of Adlarity® (donepeziltransdermal system) for treatment of patients with Alzheimer’s disease.Khoury R, Rajamanickam J, Grossberg GT.An update on the safety of current therapies for Alzheimer’s disease: Focus on rivastigmine.Ther Adv Drug Saf. 2018;9(3):171-8. doi:10.1177/2042098617750555Hager K, Baseman AS, Nye JS, et al.Effects of galantamine in a 2-year, randomized, placebo-controlled study in Alzheimer’s disease [published correction appears in Neuropsychiatr Dis Treat. 2014;10:1997].Neuropsychiatr Dis Treat. 2014;10:391–401. doi:10.2147/NDT.S57909Olivares D, Deshpande VK, Shi Y, et al.N-methyl D-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer’s disease, vascular dementia and Parkinson’s disease.Curr Alzheimer Res. 2012;9(6):746–758. doi:10.2174/156720512801322564Kuns B, Rosani A, Patel P, Varghese D.Memantine. In:StatPearls. StatPearls Publishing; 2024.Soler A, Amer G, Leiva A, et al.Continuation versus discontinuation of treatment for severe dementia: Randomized, pragmatic, open-label, clinical trial to evaluate the efficacy of continuing drug treatment in patients with severe dementia (STOP-DEM).BMC Geriatr. 2019;19(1):101. doi:10.1186/s12877-019-1122-2Massoud F, Gauthier S.Update on the pharmacological treatment of Alzheimer’s disease.Curr Neuropharmacol. 2010;8(1):69–80. doi:10.2174/157015910790909520Lim EY, Yang DW, Kim JS, Cho AH.Safety and efficacy of anti-dementia agents in the extremely elderly patients with dementia.J Korean Med Sci. 2018;33(19):e133. doi:10.3346/jkms.2018.33.e133Daiello LA, Ott BR, Lapane KL, Reinert SE, Machan JT, Dore DD.Effect of discontinuing cholinesterase inhibitor therapy on behavioral and mood symptoms in nursing home patients with dementia.Am J Geriatr Pharmacother. 2009;7(2):74-83. doi:10.1016/j.amjopharm.2009.04.002Saint-Paul LP, Martin J, Gaillard C, et al. [Sudden discontinuation of anti-dementia drugs in moderate and severe Alzheimer’s disease in a residency for dependent elderly people: a longitudinal descriptive pilot study].Therapies. 2015;70(4):313-9. doi:10.2515/therapie/2014217
Atri A.Current and future treatments in Alzheimer’s disease.Semin Neurol. 2019;39(2):227-40. doi:10.1055/s-0039-1678581
Casey DA, Antimisiaris D, O’Brien J.Drugs for Alzheimer’s disease: Are they effective?.P T. 2010;35(4):208–211.
Sharma K.Cholinesterase inhibitors as Alzheimer’s therapeutics (Review).Mol Med Rep. 2019;20(2):1479–87. doi:10.3892/mmr.2019.10374
Knowles J.Donepezil in Alzheimer’s disease: An evidence-based review of its impact on clinical and economic outcomes.Core Evid. 2006;1(3):195–219.
Corium.Corium receives FDA approval of Adlarity® (donepeziltransdermal system) for treatment of patients with Alzheimer’s disease.
Khoury R, Rajamanickam J, Grossberg GT.An update on the safety of current therapies for Alzheimer’s disease: Focus on rivastigmine.Ther Adv Drug Saf. 2018;9(3):171-8. doi:10.1177/2042098617750555
Hager K, Baseman AS, Nye JS, et al.Effects of galantamine in a 2-year, randomized, placebo-controlled study in Alzheimer’s disease [published correction appears in Neuropsychiatr Dis Treat. 2014;10:1997].Neuropsychiatr Dis Treat. 2014;10:391–401. doi:10.2147/NDT.S57909
Olivares D, Deshpande VK, Shi Y, et al.N-methyl D-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer’s disease, vascular dementia and Parkinson’s disease.Curr Alzheimer Res. 2012;9(6):746–758. doi:10.2174/156720512801322564
Kuns B, Rosani A, Patel P, Varghese D.Memantine. In:StatPearls. StatPearls Publishing; 2024.
Soler A, Amer G, Leiva A, et al.Continuation versus discontinuation of treatment for severe dementia: Randomized, pragmatic, open-label, clinical trial to evaluate the efficacy of continuing drug treatment in patients with severe dementia (STOP-DEM).BMC Geriatr. 2019;19(1):101. doi:10.1186/s12877-019-1122-2
Massoud F, Gauthier S.Update on the pharmacological treatment of Alzheimer’s disease.Curr Neuropharmacol. 2010;8(1):69–80. doi:10.2174/157015910790909520
Lim EY, Yang DW, Kim JS, Cho AH.Safety and efficacy of anti-dementia agents in the extremely elderly patients with dementia.J Korean Med Sci. 2018;33(19):e133. doi:10.3346/jkms.2018.33.e133
Daiello LA, Ott BR, Lapane KL, Reinert SE, Machan JT, Dore DD.Effect of discontinuing cholinesterase inhibitor therapy on behavioral and mood symptoms in nursing home patients with dementia.Am J Geriatr Pharmacother. 2009;7(2):74-83. doi:10.1016/j.amjopharm.2009.04.002
Saint-Paul LP, Martin J, Gaillard C, et al. [Sudden discontinuation of anti-dementia drugs in moderate and severe Alzheimer’s disease in a residency for dependent elderly people: a longitudinal descriptive pilot study].Therapies. 2015;70(4):313-9. doi:10.2515/therapie/2014217
Brodaty H.Ask the experts: When do you stop a cholinesterase inhibitor in Alzheimer’s disease?Neurodegener Dis Manag. 2011;1(3):191-2. doi:10.2217/nmt.11.30Howard R, McShane R, Lindesay J, et al.Donepezil and memantine for moderate-to-severe Alzheimer’s disease.N Engl J Med. 2012;366(10):893-903. doi:10.1056/NEJMoa1106668Lee, PE, Hsiung GYR, Seitz D, Gill SS, Rochon PA.Cholinesterase inhibitors.BCMG. 2011;53(8):404-8.Winslow BT, Onysoko MK, Stob CM, Hazlewood KA.Treatment of Alzheimer disease.Am Fam Physician. 2011;83(12):1403-12.
Brodaty H.Ask the experts: When do you stop a cholinesterase inhibitor in Alzheimer’s disease?Neurodegener Dis Manag. 2011;1(3):191-2. doi:10.2217/nmt.11.30
Howard R, McShane R, Lindesay J, et al.Donepezil and memantine for moderate-to-severe Alzheimer’s disease.N Engl J Med. 2012;366(10):893-903. doi:10.1056/NEJMoa1106668
Lee, PE, Hsiung GYR, Seitz D, Gill SS, Rochon PA.Cholinesterase inhibitors.BCMG. 2011;53(8):404-8.
Winslow BT, Onysoko MK, Stob CM, Hazlewood KA.Treatment of Alzheimer disease.Am Fam Physician. 2011;83(12):1403-12.
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