Pharmacists serve as important health advocates for people with Alzheimer’s disease


During Alzheimer’s Awareness Month in January, Canadian organizations will work to create awareness, fund research and provide services for the 564,000 Canadians living with Alzheimer’s disease.

While there is currently no cure or treatment that can stop its progression, there are medications that may reduce the severity of some symptoms.

Common symptoms of Alzheimer’s disease include memory loss, impaired judgment and reasoning, and mood and behaviour changes. The cholinesterase inhibitors are the mainstays of treatment and often prescribed to treat cognitive and functional symptoms related to memory, language, judgment and thinking. The cholinesterase inhibitors approved for use in Canada are Aricept® (donepezil), Exelon™ (rivastigmine) and Reminyl (galantamine). These drugs prevent the breakdown of acetylcholine (a-SEA-til-KOH-lean), a chemical messenger essential to learning and memory processes, supporting communication between nerve cells.

These drugs may improve the ability of impaired nerve endings to transmit messages. On average, they delay worsening of symptoms for six to 12 months for about half the people who take them. They are also generally well tolerated. Common side effects include nausea, vomiting, headache, dizziness, loss of appetite and diarrhea.

A common type of medication, memantine hydrochloride (Ebixa®), may temporarily delay worsening of symptoms for some patients with moderate to severe Alzheimer’s. It can be used alone or with Aricept to improve the ability to perform basic tasks as well as memory, attention, reason and language. (Aricept is the most commonly used cholinesterase inhibitor to treat all stages of Alzheimer’s disease.) A glutamate regulator, Ebixa’s side effects can include headache, constipation, confusion and dizziness. There are many other medications, however, that your doctor or pharmacist may recommend for treatment.

Taking Alzheimer’s medication safely

It goes without saying that the onset and progression of Alzheimer’s is stressful for patients and their caregivers. But it is easy to underestimate the effect of high levels of stress on your body and the ability to take medication as prescribed,

Putting the right care support team in place can be critical for medication safety. For example, our pharmacists are available to Express Scripts Canada Pharmacy® members 24/7 by phone to answer questions and help address issues while they in the comfort of their home. With dementia, it can sometimes be difficult to distinguish worsening cognitive decline from potential side effects, so it’s important to communicate any concerns to a professional with specialized knowledge of the condition.

Your pharmacist can be an effective advocate, helping to identify potential drug interactions with other medications, that prescriptions are being taken as directed and that any side effects are managed.

Read: A day in the life of an Express Scripts Canada pharmacist

As with all medications, follow this guide to ensure the best health outcomes.

  • Before starting any new medication, review your current medications, supplements and over-the-counter medications with your doctor and/or pharmacist. Ask about potential interactions, side effects and risks as well as expected benefits.
  • Listen carefully to your doctor’s instructions and take notes.
  • Report any side effects, and do not stop taking a prescribed medication without first consulting with your doctor or your specialty pharmacist.
  • Your pharmacist can package your medications to make it much easier to take them as prescribed and to avoid missing or doubling doses.
  • Keep a journal. It can be difficult to keep track of the symptoms of dementia, so keeping a daily journal can be helpful to both patients and caregivers. Tracking symptoms will enable your doctor to chart your progress and adjust your medication therapy.

Read: Reduce your Rx waste and safely dispose of your medication with these tips

Living with or caring for someone with Alzheimer’s can be challenging if the right resources and support are not in the right places. Learn about available resources and how your pharmacist can help.