We often think of dementia as a solely cognitive issue, but people who live with it may experience a range of other symptoms beyond problems with memory and problem-solving. Dementia can also dramatically impact broader mental health, leading to chronic anxiety. In this post, we explore medications used to treat anxiety in people with dementia and what alternatives to antianxiety drugs are potential treatments.
Anxiety often occurs with dementia. Research suggests that as many as 71% of people with dementia exhibit anxiety symptoms, and 5% to 21% have full-scale anxiety disorders. Often, anxiety levels increase as dementia progresses until people reach severe late stages. Then, anxiety levels may fall on their own. The combination of anxiety and dementia can greatly reduce the quality of life and lead to behavior and sleep problems. As a result, medical providers will often seek to treat anxiety in people with dementia through medications and other interventions.
Many drugs are available to treat anxiety disorders, but two classes of drugs are used most often to treat anxiety symptoms in people with dementia: benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).
Benzodiazepines are a class of drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of anxiety disorder as well as other conditions like seizure disorders, insomnia and agitation. These medications activate receptors in the central nervous system, increasing the body's response to a brain chemical called gamma-aminobutyric acid (GABA). This substance has a calming effect on the body.
Some benzodiazepines that may be prescribed for people with dementia include:
While benzodiazepines may reduce anxiety, they can cause side effects like drowsiness and confusion. They may make people with dementia less able to perform daily living tasks and increase the risk of falls.
SSRIs are a type of antidepressant that's also FDA-approved for treating generalized anxiety disorder. These drugs work by increasing the supply of a brain chemical called serotonin. Sometimes called the feel-good chemical, serotonin supports a positive mood, and low levels of it have been linked to depression and anxiety. An SSRI drug reduces how much serotonin the brain reabsorbs.
Some SSRIs that may be prescribed for people with dementia include:
SSRIs are frequently prescribed for people with dementia. However, there's evidence to suggest SSRIs may not be as effective at treating mental health problems in people with Alzheimer's and dementia as they are for adults without cognitive impairment.
When SSRIs are beneficial for people with dementia, high doses of the drugs are often necessary, and this increases the risk of side effects. Some side effects of SSRIs, such as sleep problems and dizziness, may be especially problematic for people with dementia. They can also cause weight changes, headaches and gastrointestinal issues.
Generally, experts recommend that people over the age of 65 shouldn't take three or more medicines that act on the central nervous system. Overmedicating can lead to drug interactions that may worsen symptoms of dementia and lead to dangerous health complications. As a result, it's important that a medical provider reviews all the drugs a person with dementia is taking regularly.
Antianxiety medications aren't the only way to help ease anxiety in people with dementia. Some other strategies include:
If your loved one has dementia and is exhibiting symptoms of anxiety, talk to their medical provider. Using antianxiety medications for treating anxiety in dementia does carry risks, but in some cases, the potential benefits may outweigh them. Also, consider how personalized therapies in a stimulating environment like the one we foster at Bethesda Gardens Loveland memory care community may benefit your loved one. Contact us today for more information about our programs.
