Drugs for Depression, Anxiety, Agitation, and Insomnia
Other drugs — including antidepressants, anticonvulsants, antipsychotics, anti-anxiety drugs, and sleep aids — are sometimes used to treat behavioral problems associated with Alzheimer’s disease.
When counseling, support groups, or other nondrug methods don’t help with depression or anxiety, doctors may prescribe one of the following drugs:
- citalopram (Celexa)
- mirtazapine (Remeron)
- sertraline (Zoloft)
- bupropion (Wellbutrin)
- duloxetine (Cymbalta)
- imipramine (Tofranil)
- escitalopram (Lexapro)
Agitation is a common symptom of Alzheimer’s that’s distressing for both care providers and the person experiencing it. A person with agitation typically appears anxious, restless, and upset and may act out verbally or physically.
In 2023, the FDA approved the antipsychotic drug brexpiprazole (Rexulti) for the treatment of agitation in Alzheimer’s disease, in spite of its raising the risk of premature death in elderly people with dementia.
Insomnia can be a problem for some people with Alzheimer’s, and one drug, suvorexant (Belsomra), is approved for treatment of insomnia in Alzheimer’s. Potential side effects of suvorexant include drowsiness the next day and impaired driving skills.
Other drugs can be used to address behavioral issues in Alzheimer’s, but because of potentially dangerous side effects, doctors prescribe them with extreme caution.
Sleep aids not specifically approved for Alzheimer’s disease can cause confusion and lead to falls.
Antipsychotics like risperidone (Risperdal) can increase the risk of death in some older people with dementia, so doctors prescribe them only as a last resort to alleviate severe hallucinations, paranoia, agitation, and aggression.
Benzodiazepines like diazepam (Valium) should also be generally avoided in patients with Alzheimer’s disease. They raise the risk of falling in elderly persons as well as the risk of becoming dependent on the drug.
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