Living with dementia

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Drugs approved for Alzheimer’s disease

There are several medications that can help with symptoms such as memory decline and changes in language, thinking abilities and motor skills. Although there is still no cure for Alzheimer's disease, those who respond to these treatments can experience improvements in their quality of life. It is important to consult with your doctor prior to starting treatment.

Cholinesterase Inhibitors

Three cholinesterase inhibitors are available in Canada to treat symptoms in people with mild to moderate Alzheimer's disease:

Cholinesterase inhibitors help by improving the ability of impaired nerve endings to transmit messages from one nerve cell to another. Eventually, nerve endings degenerate and drugs are no longer effective.

These drugs are prescribed for people with mild to moderate symptoms. Donepezil (brand name, Aricept®) has been approved for mild, moderate and severe Alzheimer's disease.

PharmaCare Coverage for Cholinesterase Inhibitors

In 2007, the Alzheimer Drug Therapy Initiative (ADTI) was developed in B.C. to address a deficit of research pertaining to this class of Alzheimer’s medications. The ultimate aim of this initiative was to determine whether or not the medications should be listed on the Provincial PharmaCare Formulary. In September 2015, the Ministry’s Drug Benefit Council met to review the evidence on the effectiveness of Cholinesterase Inhibitors. On April 1, 2016, the Ministry of Health announced a formal decision.

Effective April 1, 2016, PharmaCare covers donepezil for the treatment of mild to moderate Alzheimer’s disease as a Limited Coverage benefit through the Special Authority process. No changes will occur for people already taking the medications who received coverage through the ADTI. People who meet the criteria and are trying the medications for the first time will be asked to try donepezil before trying the other medications. Should they not be able to physically tolerate donepezil they will be able to try galantamine or the oral version of rivastigmine. However, medication changes will not be covered if donepezil is not effective in managing symptoms of Alzheimer’s disease, as evidence suggests that there is no clinical difference between the memory loss medications. In all cases, people will be prescribed the generic forms of these medications.

For more information on the decision visit the Ministry of Health’s website, download the Patient Information Sheet or speak to your doctor. The Society is grateful to the many people with dementia and caregivers who contributed their thoughts and feedback about the medications.

Memantine Hydrochloride

Information is passed from one nerve cell to another by chemicals called neurotransmitters. As Alzheimer's disease progresses, the neurotransmitter glutamate leaks out of nerve cells and is reabsorbed at levels that are toxic to the cell. Memantine hydrochloride (Ebixa®) works by blocking the reabsorption of glutamate into nerve cells.

This drug has been approved for individuals with moderate to severe Alzheimer's disease.

Side effects

As with many drugs, these medications can have side effects. Both cholinesterase inhibitors and memantine hydrochloride may cause side effects such as sleep disruption, headaches, nausea, diarrhea, constipation and drowsiness. You should consult a doctor for more information.

How drugs are approved in Canada

It is the responsibility of the Therapeutic Products Directorate (TPD) of the Health Products and Food Branch (HPFB), Health Canada, to ensure that all drugs used by the public are of high quality, safe and effective for specific conditions. This responsibility includes ensuring that drug companies have tested the drugs they wish to market and that the public is protected during each stage of the drug's development.

To learn more about the drug approval process, visit our Resources below.

Resources

Drug approval process for the treatment of Alzheimer’s disease, Alzheimer Society of Canada
How are medicines developed?, Alzheimer's Disease International

Note: The contents of this page are provided for information purposes only, and do not represent advice, an endorsement or a recommendation, with respect to any product, service or enterprise, and/or the claims and properties thereof, by the Alzheimer Society of B.C.


Last Updated: 04/14/16
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