Dementia treatment: What can help

Why the type of dementia matters

Dementia is not one condition. It is a group of conditions with different causes, including Alzheimer's disease, vascular dementia, dementia with Lewy bodies and frontotemporal dementia. Treatment depends on the cause.

A medicine that helps with one type may not help with another, so an accurate diagnosis of the type of dementia is the first step towards the right treatment and support.

Medicines for memory and thinking symptoms

These medicines do not cure dementia or stop it from progressing, but for some people they can help with symptoms for a time. Which one suits depends on the type and stage of dementia.

Acetylcholinesterase inhibitors

Donepezil, galantamine and rivastigmine are used for mild to moderate Alzheimer's disease, and donepezil is also used for severe Alzheimer's disease. They are also used for dementia with Lewy bodies (usually donepezil or rivastigmine) and Parkinson's disease dementia, and when someone has both Alzheimer's disease and vascular dementia. Side effects can include feeling sick (nausea) and loss of appetite.

Memantine

Memantine is used for severe Alzheimer's disease, and for moderate Alzheimer's disease when acetylcholinesterase inhibitors are not suitable. It can also be taken alongside one of them. It may be used for dementia with Lewy bodies when acetylcholinesterase inhibitors are not suitable, and when someone has both Alzheimer's disease and vascular dementia. Side effects can include headaches, dizziness and constipation, which are usually temporary.

Vascular and frontotemporal dementia

There is no cure for vascular dementia. Treatment aims to slow it down by treating the conditions that cause it, such as high blood pressure, high cholesterol and diabetes, and with medicines that lower the risk of another stroke. The medicines above are not used for vascular dementia on its own, but may be used when someone also has Alzheimer's disease.

The National Institute for Health and Care Excellence (NICE) advises against these medicines for frontotemporal dementia.

Treatments without medicines

NICE says group cognitive stimulation therapy should be offered to people with mild to moderate dementia, and that group reminiscence therapy, cognitive rehabilitation or occupational therapy can be considered. Ask your GP or memory service what is available near you.

• Cognitive stimulation therapy: Group activities and exercises designed to improve memory, problem-solving and language.
• Group reminiscence therapy: Talking about things and events from the past, often with prompts such as photographs, music or favourite possessions.
• Cognitive rehabilitation and occupational therapy: Working with a trained professional, such as an occupational therapist, and a relative or friend towards a personal goal, such as using a mobile phone or managing other everyday tasks.

What NICE advises against

NICE advises that acupuncture, ginseng, vitamin E supplements and herbal formulations should not be offered to treat dementia. It also advises against cognitive training, such as structured brain-training exercises, for mild to moderate Alzheimer's disease. Brain stimulation through the scalp, such as transcranial magnetic stimulation, should only be used for it in a research trial.

Help with mood, sleep and behaviour

Dementia can also bring changes in mood, sleep and behaviour, such as low mood, anxiety, agitation or distress. For agitation or distress, NICE advises looking for a cause first, such as pain, sudden confusion (delirium) or a problem with care, and using support and changes to the person's surroundings as the first approach.

NICE says antipsychotic medicines should only be offered when someone is at risk of harming themselves or others, or when agitation, hallucinations or delusions are causing them severe distress. They should be used at the lowest dose for the shortest time and reviewed at least every six weeks. In dementia with Lewy bodies and Parkinson's disease dementia, they can make movement problems worse and, in some cases, cause severe reactions.

For mild to moderate depression or anxiety in mild to moderate dementia, NICE says psychological treatments can be considered. For sleep problems, it suggests a personal plan covering sleep habits, daylight, exercise and activities.

Some commonly prescribed medicines can make memory and thinking worse. NICE says doctors should consider reducing these and, if possible, finding alternatives. Do not stop or change a medicine without talking to your doctor. Care providers can arrange consultant old age psychiatry for the people they support through our contracted service, including medication reviews and help with changes in mood, sleep or behaviour.

New medicines for early Alzheimer's disease

Lecanemab and donanemab are anti-amyloid treatments. They target amyloid, a protein that builds up in the brain in Alzheimer's disease, and aim to slow the disease down. They do not cure or reverse it.

The Medicines and Healthcare products Regulatory Agency (MHRA) licensed lecanemab on 22nd August 2024 and donanemab on 23rd October 2024, for adults in the early stages of Alzheimer's disease who have one or no copies of the APOE4 gene.

Before treatment, tests such as a PET scan or a lumbar puncture must confirm amyloid in the brain, and a genetic test checks the APOE4 gene. Some people cannot have them, for example because of changes seen on an MRI scan or other medicines they take.

Both are given as a drip into a vein (an infusion) in a healthcare setting, lecanemab every two weeks and donanemab every four weeks, with MRI scans before and during treatment to check for side effects. The most common side effects are reactions to the infusion, headaches and amyloid-related imaging abnormalities (ARIA). Infusion reactions can cause fever and flu-like symptoms. ARIA is most often temporary swelling in the brain or small spots of bleeding. Most cases show only on a scan and cause no symptoms, but in a small number of people they cause serious symptoms.

On the NHS

In June 2025, NICE's final draft guidance did not recommend them for NHS use, because it found their benefits too small to justify the costs. After appeals, NICE began looking at the evidence again in March 2026 and consulted on new draft guidance in April 2026. Its final decision is still to come: when we checked on 9th October 2026, NICE had not published final guidance on either medicine.

Research into new treatments is continuing. Anyone aged 18 or over in the UK, with or without dementia, can register their interest in taking part in studies through Join Dementia Research, which is run by the National Institute for Health and Care Research (NIHR) with Alzheimer Scotland, Alzheimer's Research UK and Alzheimer's Society.

Treatment after a private diagnosis

After a private assessment with us, you receive a written report with your diagnosis and care plan. With your consent, we send it to your GP, so your care can continue through the NHS or privately.

If medicines are recommended

NICE says medicines for memory and thinking symptoms should be started on the advice of a clinician with the right expertise, such as a psychiatrist, and the first prescription can then be made by your GP. Your GP decides whether to prescribe them on the NHS. GPs prescribe when they are satisfied a medicine meets your needs, and some ask for a specialist to prescribe instead.

If your GP does not prescribe, our consultants can prescribe privately where clinically appropriate, through dispensary partners who distribute nationally.

Questions about dementia treatment

Can dementia be slowed down?

Some treatments aim to. In vascular dementia, treating the causes, such as high blood pressure, may help slow it down. The new anti-amyloid medicines aim to slow early Alzheimer's disease, but they suit only some people and are not routinely available on the NHS.

Can I get dementia treatment privately?

Yes. After a diagnosis, you can see a private specialist for help with changes in mood, sleep or behaviour and for medication reviews. Your GP can also continue your care through the NHS. Where clinically appropriate, our consultants can prescribe privately, through dispensary partners who distribute nationally.

Sources

1. NHS: What are the treatments for dementia?Last reviewed 24th July 2023
2. NHS: Vascular dementia treatmentLast reviewed 8th June 2023
3. National Institute for Health and Care Excellence: Dementia: assessment, management and support for people living with dementia and their carers (NG97)Last reviewed 26th September 2023
4. Medicines and Healthcare products Regulatory Agency: Lecanemab licensed for adult patients in the early stages of Alzheimer's disease22nd August 2024
5. Medicines and Healthcare products Regulatory Agency: Donanemab licensed for early stages of Alzheimer's disease in adult patients who have one or no copies of apolipoprotein E4 gene23rd October 2024
6. Electronic medicines compendium: Lecanemab, summary of product characteristicsRevised 1st July 2026
7. Electronic medicines compendium: Donanemab, summary of product characteristicsRevised 11th March 2026
8. National Institute for Health and Care Excellence: Final draft guidance finds benefits of 2 Alzheimer's treatments remain too small to justify the additional costs to the NHS19th June 2025
9. The Pharmaceutical Journal: NICE opens consultation on previously-rejected Alzheimer's treatments donanemab and lecanemab1st April 2026