How is Lewy body dementia (LBD) treated? Is there a cure?

There is no cure for Lewy body dementia (LBD). Medications and nonmedical therapies, like physical, occupational and speech therapies, manage symptoms as much as possible.

Medications called cholinesterase inhibitors (Aricept®, Exelon®, Razadyne®) help manage the cognitive symptoms of LBD. Memantine (Namenda®) may also be helpful. Symptoms of Parkinsonism, like tremors, are usually treated with levodopa, a drug commonly used to treat Parkinson’s disease.

You or your loved one may also benefit from treatments like physical therapy or speech therapy. These treatments help retain physical function and improve muscle strength.

What complications are associated with medications used to treat Lewy body dementia (LBD)?

Up to 50% of people living with Lewy body dementia (LBD) can have severe side effects when treated with certain antipsychotic medications. These are known as the typical or traditional antipsychotics and include such drugs as thoridazine, haloperidol, chlorpromazine and perphenazine. This class of older, first-generation antipsychotics can cause sedation and make cognitive symptoms and movement problems (Parkinsonism) worse. A life-threatening reaction to an antipsychotic medication, called neuroleptic malignant syndrome, is possible. Symptoms include rigid muscles, changing blood pressure, high fever, confusion and fast heart rate. Contact your healthcare provider immediately if you or your loved are taking an antipsychotic and develop these symptoms.

Visual hallucinations and behavioral changes may be treated with the newer, atypical antipsychotic medications pimavanserin (Nuplazid®), quetiapine (Seroquel®) or clozapine (Clozaril®). However, because all antipsychotic medications – both older, typical medications and newer atypical medications – can increase the risk of death in elderly patients with dementia, you and your healthcare provider should carefully discuss the risks and benefits and using these medications.

Other medications, like antidepressants or sedative antihistamines, may increase confusion in people with LBD.

Talk with your healthcare provider about all the medications you or your loved one takes. Many drugs have side effects that can worsen symptoms or add to them. If medications to treat symptoms are not working to decrease symptoms, others can be tried. Never hesitate to talk to your healthcare with your concerns or to ask questions.

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