Treatment

Treatment can be challenging, and there's no cure for Lewy body dementia. Doctors treat the individual symptoms.

Medications

  • Cholinesterase inhibitors. These Alzheimer's disease medications, such as rivastigmine (Exelon), work by increasing the levels of chemical messengers believed to be important for memory, thought and judgment (neurotransmitters) in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Possible side effects may include gastrointestinal upset, excessive salivation and tearing, and frequent urination. These are not FDA approved for Lewy body dementia.
  • Parkinson's disease medications. These medications, such as carbidopa-levodopa (Sinemet) may help reduce parkinsonian symptoms, such as rigid muscles and slow movement. However, these medications may also increase confusion, hallucinations and delusions.
  • Medications to treat other symptoms. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems.

If possible, avoid medications with anticholinergic properties, which can worsen cognition or dopamine agonists, which can cause hallucinations.

First-generation antipsychotic medications, such as haloperidol (Haldol), should not be used to treat Lewy body dementia. They may cause severe confusion, severe Parkinsonism, sedation and sometimes even death. Very rarely, certain second-generation antipsychotics may be prescribed for a short time at a low dose but only if the benefits outweigh the risks.

Therapies

Because antipsychotic drugs can worsen Lewy body dementia symptoms, it might be helpful to initially try nondrug approaches, such as:

  • Tolerating the behavior. Many times a person with Lewy body dementia isn't distressed by the hallucinations. In these cases, the side effects of medication may be worse than the hallucinations themselves.
  • Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to function.
  • Offering soothing responses. A caregiver's response may worsen behavior. Avoid correcting and quizzing a person with dementia. Offer reassurance and validation of his or her concerns.
  • Creating daily routines and keeping tasks simple. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day can be less confusing.

Alternative medicine

Frustration and anxiety can worsen dementia symptoms. These techniques may help promote relaxation:

  • Music therapy, which involves listening to soothing music
  • Pet therapy, which involves the use of animals to improve moods and behaviors in dementia patients
  • Aromatherapy, which uses fragrant plant oils
  • Massage therapy