What treatment can do
The NHS says there is currently no cure for dementia, but there are medicines and other treatments that can help with symptoms. Treatment aims to:
- help memory and thinking for a time
- support independence and wellbeing
- manage distress, low mood, sleep problems and changes in behaviour
- support families and carers
Which treatments are suitable depends on the type of dementia, how advanced it is, and the person’s other health needs and wishes.
Acetylcholinesterase inhibitors
These medicines stop an enzyme from breaking down acetylcholine, a chemical messenger that helps brain cells communicate. Levels of acetylcholine fall in Alzheimer’s disease.
There are three:
- donepezil
- galantamine
- rivastigmine
NICE recommends them for mild to moderate Alzheimer’s disease. NICE also recommends offering donepezil or rivastigmine for mild to moderate dementia with Lewy bodies.
NICE says treatment should be started on the advice of a clinician with the right expertise, usually the memory service. After that, the GP often continues the prescription.
Side effects
The NHS says common side effects include feeling sick and loss of appetite. These often settle within about two weeks. Tell the doctor about any side effects. Do not stop the medicine without talking to them first.
Memantine
Memantine works differently. It blocks the effects of too much of a chemical called glutamate in the brain.
NICE recommends memantine for:
- moderate Alzheimer’s disease, if acetylcholinesterase inhibitors are not suitable or not tolerated
- severe Alzheimer’s disease
- adding to an acetylcholinesterase inhibitor in moderate disease (consider) or severe disease (offer)
For severe dementia with Lewy bodies, NICE says memantine may be considered.
When these medicines are not used
- Vascular dementia: NICE says these medicines should only be considered if the person may also have Alzheimer’s disease, Lewy body dementia or Parkinson’s disease dementia. The focus is on treating blood pressure, cholesterol and other risks. See vascular dementia.
- Frontotemporal dementia: NICE says acetylcholinesterase inhibitors and memantine should not be offered, as they do not help. See frontotemporal dementia.
- Supplements: NICE says ginseng, vitamin E supplements and herbal formulations should not be offered to treat dementia.
New antibody medicines
Lecanemab (brand name Leqembi) and donanemab (brand name Kisunla) are a newer type of medicine. They are antibodies that help remove amyloid, one of the proteins that builds up in Alzheimer’s disease.
Licence
The UK medicines regulator, the MHRA, licensed both in 2024 for some adults with early Alzheimer’s disease, meaning mild cognitive impairment or mild dementia caused by Alzheimer’s disease. Alzheimer’s Society says lecanemab is not licensed for people with moderate or later-stage Alzheimer’s disease, other types of dementia, or people with two copies of a gene variant called APOE4.
How well they work
NICE says the medicines have been shown to delay progression from mild to moderate Alzheimer’s disease by about 4 to 6 months. Alzheimer’s Research UK describes their effects as modest. They do not stop the disease.
Risks
Alzheimer’s Society explains that lecanemab can cause swelling or small bleeds in the brain, known as ARIA (amyloid-related imaging abnormalities). Most people with ARIA in the trial had no symptoms, and the changes were only found on MRI scans. But a small number of cases were serious. People taking these medicines need specialist assessment and regular MRI scans. Lecanemab is given by a drip into a vein.
NHS availability in 2026
Cognitive stimulation therapy
Cognitive stimulation therapy (CST) involves group activities and exercises. The NHS says they are designed to improve memory, problem-solving skills and language ability. Sessions are usually social and enjoyable.
NICE recommends offering group CST to people with mild to moderate dementia. Ask the memory service or GP what is available locally.
Other non-drug approaches
NICE says the following may be considered:
- group reminiscence therapy: talking about past experiences, often using photos, music and objects
- cognitive rehabilitation or occupational therapy: working with a professional towards personal goals, such as using a phone or cooking safely
NICE says cognitive training (repeated computer-type brain exercises) should not be offered to treat mild to moderate Alzheimer’s disease, and that acupuncture should not be offered to treat dementia.
Changes in behaviour and mood
As dementia progresses, some people have agitation, aggression, hallucinations, delusions, low mood or problems sleeping. Doctors call these behavioural and psychological symptoms of dementia.
Look for causes first
The NHS says behaviour often comes from fear, confusion or feeling unsafe. Sudden changes can be caused by pain, infection (such as a urinary tract infection), untreated depression or medicine side effects.
NICE says that before any medicine is used, there should be a structured assessment to explore possible reasons for distress and address physical or environmental causes.
Non-drug approaches first
NICE says psychosocial and environmental approaches should be offered first to reduce distress. These might include:
- treating pain, constipation or infection
- making sure the person is eating, drinking and sleeping enough
- a calm, familiar routine
- meaningful activities, music and time outdoors
- adjusting noise, lighting and the layout of the home
- responding to the feelings behind the behaviour
See caring for someone for practical tips.
Antipsychotic medicines
If an antipsychotic is considered, NICE says:
- the benefits and harms should be discussed with the person and their family or carers
- the lowest effective dose should be used, for the shortest possible time
- the person should be reassessed at least every 6 weeks
- the medicine should be stopped if there is no clear ongoing benefit, after discussion
Never stop or change a medicine without talking to the prescriber.
Reviewing other medicines
NICE asks doctors to consider reducing medicines that add to “anticholinergic burden”, as these can make thinking problems worse. Ask the GP or pharmacist for a regular medicines review.
Taking part in research
Research into dementia treatments is moving quickly. Join Dementia Research is a UK service that matches volunteers with research studies. It is run by the NIHR with Alzheimer’s Society, Alzheimer’s Research UK and Alzheimer Scotland.
For support in the meantime, see living well and support and helplines.