Treatment and management of dementia

If you are diagnosed with dementia, your doctor and a specialist, like a neurologist, psychogeriatrician, geriatrician or psychiatrist, will usually be involved in prescribing medications for you.

There is currently no known medication that can cure dementia. But medication can treat some of the symptoms that come with different forms of dementia. They can also help with some of the conditions that come along with dementia, like anxiety and sleep problems.

Questions to ask about medications

When your doctor prescribes a medication for you, here are some questions you can ask:

• How does this medication help?
• How will it take before I notice its benefits?
• What are its side-effects? If I feel those side-effects, what should I do?
• How often should I take it, and how much?
• What should I do if I miss a dose?
• What happens if I need to suddenly stop taking it?
• How will it interact with my other medications?
• Will it affect my other medical conditions?
• When should I come back to check how well it’s working?
• Will it get less effective as my dementia progresses?
• Is it available at a subsidised rate?

Taking medication

Take your medications exactly the way your doctor tells you. Make sure you know the dose, the time of day to take them and if you should take them with or without food.

There are some medicines you can take when you need them. Others need to be taken regularly to help. Ask your doctor which your medication is.

Some medicines take time to work. It might take several weeks for you to feel a medicine working. Your doctor will tell you how long.

If you’re feeling side-effects, especially strong side-effects, talk to your doctor.

Only take medications that have been prescribed to you. Don’t share your medication with anyone else. Make sure medicines are kept safe and secure.

Keep a record of your medications, and any other treatments you’re getting. Take this record when you go to the doctor: it will help them choose the best treatment for you.

There are many different types of dementia, so there are many kinds of medicines used to treat people with dementia.

Here are some of the more common medical treatments for dementia.

Donanemab for early Alzheimer’s disease

Donanemab (also known by the brand name KISUNLA) is a prescription medicine, created by pharmaceutical company Eli Lilly, used to treat early symptomatic Alzheimer’s disease.

As of 2025, donanemab is the first new treatment registered in Australia for early Alzheimer’s disease in 25 years, and the first treatment registered in Australia that works to address its underlying cause.

Donanemab is most effective when administered during the early stages of Alzheimer's disease to slow its progression.

How does donanemab work?

Alzheimer’s disease is associated with the build-up of a protein in the brain called amyloid. When too much amyloid is made, it can create bundles, more commonly known as plaques.

Donanemab is a treatment that targets and breaks down amyloid plaques in the brain, aiming to slow the progression of Alzheimer’s disease by mitigating cognitive decline and memory loss.

Donanemab does not cure Alzheimer’s disease, but it can help slow its progression and help you maintain independence for longer.

Is donanemab registered in Australia?

In 2025, the Therapeutic Goods Administration (TGA) registered donanemab to be prescribed in Australia for the treatment of adults with early symptomatic Alzheimer's disease who:

• carry one copy of a gene called apolipoprotein E4 (APOE ε4) in their DNA
• don’t carry this gene but have a confirmed presence of amyloid plaque in their brain, usually confirmed via an amyloid positron emission tomography (PET) scan or cerebrospinal fluid (CSF) analysis, collected via a lumbar puncture procedure.

Donanemab is not registered to be used by those who have two copies of the APOE ε4 gene.

In Australia, donanemab is registered to treat people diagnosed with either:

• early symptomatic Alzheimer’s disease
• mild cognitive impairment due to Alzheimer’s disease.

How can I access donanemab?

Only physicians experienced in the diagnosis and treatment of Alzheimer's disease will be able to prescribe donanemab to eligible patients.

The number of sites where you can access donanemab is growing. There are specialised clinicians who are working together to provide this therapy in private clinics and infusions centres, and potentially via public private partnerships. Speak to your General Practitioner for a referral or to your specialist about how you can access donanemab in an area close to you.

What can I expect when prescribed donanemab?

Donanemab is given in an infusion centre through a drip in the vein of the arm (also known as an IV infusion), once every four weeks (or at least 21 days apart). Each infusion takes at least 30 minutes. After the infusion, there is a further 30-minute monitoring period at the infusion centre.

Before you start on donanemab, you will need a recent (within 6 months) baseline brain magnetic resonance imaging (MRI) scan. Your doctor will periodically request further MRI scans:

• prior to the second dose (one month)
• prior to the third dose (two months)
• prior to the fourth dose (usually three months)
• prior to the seventh dose (usually six months).

The maximum time on donanemab treatment is 18 months. However, you and your doctor may consider ending treatment earlier, after reaching a near-normal level of amyloid. In a clinical study, people were able to stop taking donanemab if their amyloid plaques were reduced to a predefined level.

Does donanemab have side effects?

Like all medicines, donanemab can cause side effects. One of the most common is amyloid-related imaging abnormalities (ARIA). ARIA can present as temporary swelling in the brain or small spots of bleeding in or on the surface of the brain. In some cases, large areas of bleeding may occur. Although ARIA does not usually cause any symptoms, some people may experience headache, confusion, dizziness, speech changes, nausea/vomiting, vision changes, tremor and seizures.

Donanemab can also cause certain types of allergic reactions, some of which may be serious and life-threatening . These typically occur during infusion or within 30 minutes after the infusion. Falls and infusion-related reactions are other commonly reported side effects.

Does donanemab interfere with any other medications?

You should share a list of your current medications with your healthcare provider prior to treatment.

How to learn more about donanemab

To find out more about donanemab, talk to your doctor.

Currently, doctors are able to prescribe donanemab on private prescription. Donanemab is not available on the Pharmaceutical Benefits Scheme (PBS) at this stage.

For more information about donanemab, visit:

• Product Information for healthcare professionals
• Consumer medicine Information for consumers.

Cholinesterase inhibitors for Alzheimer’s disease

Cholinesterase inhibitors are medications that stop important chemicals in your brain breaking down. Those chemicals, which are called acetylcholine and butyrylcholine, help your brain cells communicate with each other.

Cholinesterase inhibitors can help improve your memory and your ability to carry out day-to-day activities if you have Alzheimer’s disease.

Cholinesterase inhibitors may also help with motivation, mood and confidence, and with delusions and hallucinations.

If cholinesterase inhibitor medications are effective for you, they may reduce your need to take other medications. However, in higher doses they may make you feel more agitated or give you insomnia with nightmares.

Cholinergic medications for Alzheimer’s disease

Cholinergic medications work differently to cholinesterase inhibitors. Instead of stopping those important communication chemicals in your brain from breaking down, they either produce more of those chemicals, or they act just like those chemicals, doing the same thing in your brain.

Cholinergic treatments are approved for use for people with mild to moderate Alzheimer’s disease.

It’s possible to receive these medications at a lower price if a doctor or psychiatrist diagnoses you with Alzheimer’s disease.

If you show improvement on a commonly used test of mental function in the first six months of treatment, you may be able to keep getting subsidised medication.

Memantine for Alzheimer’s disease

Memantine is the most recent antidementia medication to be developed.

Memantine targets a different brain chemical, called glutamate, that is present in high levels if you have Alzheimer’s disease. Memantine blocks glutamate and prevents too much calcium moving into the brain cells causing damage.

This may have a positive effect on your mood, behaviour and agitation.

It is the first in a new class of therapies and acts quite differently to the other Alzheimer’s disease treatments that are currently approved for treatment in Australia.

Memantine is the first medication approved for people with middle to later stages of Alzheimer’s disease.

It is available at subsidised rates under the Pharmaceutical Benefits Schedule if you meet the criteria for diagnosis and stage of disease.

Antidepressant medications

It’s very common to feel symptoms of depression when you have dementia. You might experience depression after getting your diagnosis. Later, the effects of dementia on your brain can also cause symptoms of depression.

If you’re feeling depressed, talk to your doctor. They can help in many ways. One way is with antidepressant medication.

Antidepressants can help improve your mood and control the irritability and rapid mood swings that often occur in dementia and following a stroke.

Your doctor will usually prescribe antidepressant medication for at least six months.

Antidepressants take time to work. It can be three to six weeks before you will feel better from taking them. You might feel the side-effects within a few days of starting the medication.

Take your antidepressant medication exactly as your doctor tells you to.

Anti-anxiety medications

Feeling afraid, worried, nervous or stressed sometimes is a normal part of life.

But if you’re feeling very anxious, in sudden attacks or over time, in a way that is too much for the situation and doesn’t go away, you may have an anxiety disorder.

If you feel this way, talk to your doctor. There are different ways to treat anxiety disorders, but one is with medication.

Your doctor might prescribe a medication called a benzodiazepine at first. These are only used for a short time. They are sedatives that help you feel calmer and sleep.

Your doctor might also prescribe an antidepressant medication for your anxiety. This is normal. It can take a few weeks for the antidepressant to start working, and you’ll probably take it for at least six months.

Both kinds of anti-anxiety medication can have side-effects. Talk to your doctor about what you might experience with your medication.

Take your anti-anxiety medication exactly as your doctor tells you to.

Sleep medications

Dementia can change the way you sleep. You may need much more or much less sleep. You might find yourself struggling to get to sleep or stay asleep.

Some dementia medications can also make you drowsy during the day, which makes you less able to sleep at night.

It’s different for everyone, but some form of disturbed sleep is very common in people with dementia.

If you’re struggling with sleep, talk to your doctor. They can give you good advice and treatment, and they might prescribe medications for sleep.

The most common sleep medications are called hypnotics, or sedatives. They help you get to sleep at bedtime.

Taking sedatives can make you confused or unsteady on your feet if you wake up while they’re still working. Some people also experience incontinence while they sleep while using sedatives.

Talk to your doctor about the best sleep medication for you. Take your sleep medication exactly as your doctor tells you to.

Antipsychotic medication

Antipsychotics (also known as neuroleptics or major tranquillisers) are medications that were originally developed to treat people with schizophrenia. The use of antipsychotics in people with dementia remains controversial and clinical trials are in progress to better determine their effectiveness.

Unproven treatments

These treatments have no strong evidence to show they’re effective in treating dementia or its symptoms.

The future of dementia treatment

Trials are in progress assessing benefits of an Alzheimer’s vaccine (having a component of the amyloid protein found in plaques), inhibitors of the enzymes that produce amyloid and therapies using nerve growth factor. These approaches may prove to be effective, but much more work is needed.

Researchers around the world are working to develop effective treatments for dementia, and eventually to find a cure. Much of this work is focussed on Alzheimer’s disease, the most common form of dementia.