Font Size

Dementia With Lewy Bodies (cont.)


Medications can be used torelieve depression, treat agitation and hallucinations, and improve cognition and/or alertness.There is a great deal of controversy about whether or not acetylcholinesterase inhibitors may slow the rate of cognitive decline or slow the need for nursing home placement.

Acetylcholinesterase inhibitors: These drugs increase the level of acetylcholine in the brain, which is low in DLB. These drugs can decrease fluctuations in cognition, increase alertness, and improve memory. Examples include donepezil (Aricept), tacrine (Cognex), rivastigmine (Exelon), and galantamine (Reminyl).

Atypical neuroleptics: These drugs can relieve hallucinations, delusions, and agitation. They do not worsen motor symptoms as much as "typical" older neuroleptic drugs do. Examples include risperidone (Risperdal), olanzapine (Zyprexa),and quetiapine (Seroquel).

Antidepressants: The first choice for treatment of depression in DLB is the selective serotonin reuptake inhibitors, which do not deplete acetylcholine. Examples include sertraline (Zoloft), fluoxetine (Prozac), venlafaxine (Effexor), and paroxetine (Paxil).

Dopamine-promoting drugs: These drugs work in various ways to increase the level of the neurotransmitter dopamine in the brain. Although low dopamine level is partly responsible for the motor symptoms of DLB, these drugs often cannot be tolerated because of the side effects. They can, for example, worsen hallucinations. Examples include combined levodopa and carbidopa (Sinemet), which combines a dopamine precursor with a drug that maximizes its usefulness in the brain, and pramipexole (Mirapex) and ropinirole (Requip), which mimic the effects of dopamine.

Antioxidants: These agents counteract excess oxidation, which may contribute to the brain cell damage in DLB. Formal studies are lacking to determine their usefulness in slowing the disease progression. The only example now in widespread use is alpha-tocopherol, or vitamin E (Vita-Plus E Softgels, Vitec, Aquasol E).

Medically Reviewed by a Doctor on 8/6/2014
Medical Author:
Medical Editor:
Medical Editor:
Medical Editor:

Must Read Articles Related to Dementia With Lewy Bodies

Alzheimer's Disease
Alzheimer Disease Alzheimer's disease (AD) is the most common cause of dementia in industrialized nations. Dementia is a brain disorder that interferes with a person's ability to...learn more >>
CT Scan (CAT Scan, Computerized Axial Tomography)
CT Scan History CT was discovered independently by a British engineer named Sir Godfrey Hounsfield and Dr. Alan Cormack. It has become a mainstay for diagnosing med...learn more >>
Dementia Medication Overview
Dementia Medication Overview Most diseases that cause dementia are progressive, which means that persons with the disease get worse over time. Unfortunately, no curative treatment for demen...learn more >>

Read What Your Physician is Reading on Medscape

Dementia With Lewy Bodies »

Frederick Lewy first described Lewy bodies (LBs), cytoplasmic inclusions found in cells of the substantia nigra in patients with idiopathic Parkinson's disease, in 1914.

Read More on Medscape Reference »

Medical Dictionary