With any health condition, support and treatment are the two things that all patients seek.

And in most cases – but not all – treatment usually includes some form of medication.

But one of the challenges with medication is that they aren’t always effective, and some that do help with certain symptoms, bring on other challenging side effects.

This is even the case with drugs that are prescribed for the various forms of dementia.

A new study, which was published in the Journal of the American Geriatrics Society, looked it to the safety and effectiveness of four different cognitive enhancers that are commonly used by people living with Alzheimer’s disease.

These cognitive enhancers are usually taken to enhance concentration, memory, alertness and moods.

The study focussed on the follow four drugs;

  • Donepezil,
  • Rivastigmine
  • Galantamine
  • Memantine

“Alzheimer’s dementia is the most common form of dementia…and most people who have moderate to severe Alzheimer’s will be on these medications,” said Dr. Andrea Tricco, the lead author of the study.

Though there have been reviews on the use of each of these Alzheimer’s drugs in the past, this is the first research that has ever compared and ranked them based on safety and effectiveness.

“This analysis will give both patients and clinicians a full picture of how each of these drugs will likely affect their cognition, as well as their overall health.”

The research particularly focussed on each drug’s’ effectiveness in patient outcomes, which included cognition, function behaviour, global status, mortality, serious adverse events, falls, bradycardia, headache, diarrhea, vomiting and nausea.

What the research found was that donepezil was most likely to improve cognition in people with Alzheimer’s across all effectiveness outcomes, including cognition, behavior and overall health – but there was a catch.

People who took donepezil experienced severe side-effects such as nausea, vomiting and diarrhea.

However, donepezil was also the only cognitive enhancer that reached the “minimal clinically important threshold” – what this means was that it made enough of a difference that changes were seen on the Alzheimer’s Disease Assessment cognition scale.

The study looked at 142 different trials of the four commonly used cognitive enhancers, between 1996 and 2015, which were either administered alone or in combination. In total there were 33,889 patients across these 142 trials.

The data analysed showed that there was no significant risk of serious harm, falls or reduced heart rate was associated with any of the four medications.

The researchers warned that though the drugs appear safe, their results must be interpreted cautiously because trial participants may have less comorbidity and fewer adverse effects than those treated with these drugs in clinical practice.

The findings of the current study will help guide patients and clinicians who are making decisions about the best course of treatment for Alzheimer’s dementia, said Dr. Tricco.

“The more information we are able to gather about how each of these medications can affect a patient’s cognition and health, the more likely we are to be able to improve their health outcomes,” she said.

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