Drug interactions

A person with Alzheimer's disease may be taking medicines to treat symptoms of the disease, as well as other health problems (high blood pressure, diabetes, high cholesterol, etc.). However, when a person takes many medications--a situation called polypharmacy--there is an increased risk of adverse reactions, including confusion, agitation, sleepiness or sleeplessness, mood swings, memory problems, stomach upset, and/or changes in appetite.

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While it may become necessary for a person to take medicine to treat the severe symptoms of Alzheimer's disease--such as hallucinations or aggressive behavior--some of these medications can worsen other symptoms of the disease. For example:

• Some sedatives or hypnotics, such as benzodiazepines and barbiturates, can cause confusion, increased memory impairment, and slowed reactions, which can lead to falls.
• Certain antidepressant medicines, particularly the tricyclic antidepressant amitriptyline (Elavil), can cause sedation. These drugs also can react with the medicines used to treat Alzheimer's, including rivastigmine (Exelon), donepezil (Aricept), and galantamine (Razadyne).
• Some antipsychotics (medicine used to treat hallucinations) can cause sedation, cognitive impairment, and drops in blood pressure. They also can react with the medicines used to treat Alzheimer's disease.

It is important to discuss the pros and cons of these medication options with a doctor before making a decision regarding medication.

In addition, it is important to consider the possible side effects of over-the-counter medicines, including cough and cold remedies, and sleep medicines. These drugs also may react with other medications taken by the person with Alzheimer's disease. It is best to consult a doctor before using over-the-counter medication.