Medicines and dementia: what you need to know
Medicines do not have to be part of your care plan for dementia, nor play a large role in your life.

Keep track of medicines and access important health info any time and anywhere, especially in emergencies.
Medicines do not have to be part of your care plan for dementia, and if they are, they do not have to play a large role in your life.
NPS MedicineWise and Dementia Australia (formerly Alzheimer's Australia) have prepared downloadable materials to help you ask questions and talk with people close to you and the health professionals involved in your care about how you would like to be supported.
The main resource is an information booklet, designed to help you:
Date published : 4 January 2021
To order a printed copy of this booklet please contact the Dementia Australia office in your state or territory (formerly Alzheimer's Australia).
The following fact sheets include information and tips to help with decisions around your care,
Date published : 4 January 2021
Date published : 4 January 2021
Date published : 4 January 2021
This initiative is funded by the Alzheimer’s Australia National Quality Dementia Care Initiative with support from J.O. & J.R. Wicking Trust.
Every person with dementia is an individual who will react in their own way to events or factors in their environment.1 People with dementia can become upset and distressed as a result of medical, physical, emotional or environmental factors2 and these expressions are often indicative of an unmet need.
It is important to understand why people with dementia become distressed and find ways to help or prevent it.3
Health professionals refer to expressions of distress as behavioural and psychological symptoms of dementia (BPSD).
There may be one or more underlying factors which can lead to distress or a feeling of dissatisfaction in people with dementia. Factors contributing to stress may be medical, physical, environmental or emotional (see below).2
The quality or practice of care given to the person with dementia may also contribute to emotional stress, for example, use of physical restraints or disregarding their social and cultural needs.2
Medical |
Physical |
Environmental |
Emotional |
Sleep disruption/ deprivation Other medical conditions such as depression, urinary tract infection Delirium Chronic illness |
Discomfort such as pain, fever or constipation Not able to communicate Immobility Complicated tasks |
Allowing strangers into the home Change to physical environment Limited care Fear |
Fear Lack of respect, recognition or trust in social interactions and relationships Feelings of worthlessness or sadness Grief Loneliness |
The underlying cause leading to distress should be identified and addressed by families, friends or carers using a positive approach. People with dementia may use hand gestures, body language, facial expressions, eye contact and actions in their attempts to help their family members, friends or carers identify the reasons for their distress. Below is a checklist of suggestions to help prevent distress.4
Communication |
Personal care delivery |
The care environment |
Speak slowly and calmly Avoid point finger-pointing, scolding or threatening Make eye contact where appropriate Use person’s name/title Consider cultural background when communicating Avoid correcting mistakes |
Do not disagree Respect the person’s thoughts even if incorrect Consider pain as a reason for distress Allow for some privacy Talk to the doctor about other illnesses such as constipation, urinary tract infection, headache etc that may be reasons for distress Offer choices |
Ensure routine activity Avoid tasks that trigger stress Ask the person to take part in an enjoyable activity Be flexible with meal times Ensure the environment is not noisy or cluttered Declutter table settings |
Managing emotional stress through simple strategies and changes in the delivery of care is primarily recommended for addressing mood or distress symptoms.1 If medical treatment is necessary, your doctor will tailor treatment to your circumstances, for example, prescribing antidepressants for moderate to severe depression.2
Medicines should be reviewed regularly by a health professional and when to review depends on the medicine. Talk to the doctor or other health professional about incorporating medicine reviews into a care plan. Using a medicines list can help with managing medicines. Talk to the doctor or other health professional about the active ingredient and brand names of the medicines you are taking.
Groups of medicines that may be used to help reduce symptoms of distress are described below.1,3,4
Some of the symptoms of Alzheimer disease are thought to result from a lack of acetylcholine, which is a chemical messenger in the brain. These medicines help increase the amount of this chemical in the brain which can help with the symptoms of Alzheimer disease.
Target distress symptom |
Common side effects |
Efficacy |
agitation |
diarrhoea, anorexia, insomnia, vivid dreams, urinary incontinence |
delays cognitive decline by 6 months in 25%– 50% of people with dementia, and 1 year in 12%–20% of people with mild to moderate Alzheimer disease |
Memantine works by blocking a certain type of receptor in the brain and protecting these receptors from a chemical called glutamate, which might be contributing to brain degeneration. These receptors are called NMDA receptors which are involved in transmitting nerve signals in the brain, eg, in learning and memory.
Target distress symptom |
Common side effects |
Efficacy |
agitation |
confusion, drowsiness, insomnia, hallucinations |
moderately slows cognitive decline |
Antipsychotics work by changing the effect of certain chemicals in the brain (eg, dopamine, serotonin, noradrenaline and acetylcholine) with the main effect on dopamine. These chemicals can impact behaviour, mood and emotions. There are many different antipsychotics and they are split into two categories – the newer or atypical antipsychotics, and the older typical antipsychotics.
Target distress symptom |
Common side effects |
Efficacy |
psychosis, aggression |
sedation, anxiety, restlessness and agitation, pneumonia, increased heart rate. Has been associated with increased risk of death |
of limited use for people with dementia |
Antidepressants are thought to work by increasing certain chemicals in the brain. Certain chemicals, such as serotonin and noradrenaline are linked to mood and emotion.
Target distress symptom |
Common side effects |
Efficacy |
depression |
sleep disturbance, headache, drowsiness, tremors, nausea, anorexia, urinary incontinence |
can take 2 weeks or more to see improvements in mood |
Anxiolytics are medicines to help with the symptoms of anxiety. As with the medicines listed above, they also work by influencing levels of different chemicals in the brain.
Target distress symptom |
Common side effects |
Efficacy |
agitation, anxiety, sleep disorder |
falls, confusion, rebound insomnia |
effective for treating anxiety but recommended for short-term use only (2–4 weeks) |
A person with dementia (and you, as a carer or family member of a person with dementia) has a legal right to refuse treatment.
Being diagnosed with dementia doesn’t mean a person is unable to make decisions on medical treatment and management.1 They have the right to make decisions if they:
Under these circumstances the person with dementia can initiate a discussion with their doctor on the risks and benefits of medical treatment for distress and have the doctor record their wishes about treatment on their medical record.
If the person is unable to verbally communicate with family members, friends or carers, they can write down their wishes about the medical treatment they want or don’t want and the person making the decision on their behalf can use this as guidance.
Families, friends or carers can make decisions for the person with dementia if they do not meet the above criteria. Carers making a decision on behalf of the person with dementia should be guided by the values and expressed wishes of the person with dementia.3 If the person with dementia has made an Advance Directive (legally binding document stating their wishes for treatment), the carer is legally bound to follow the Directive.3
People with dementia may experience other medical problems or conditions that may or not be related to dementia. Each person is different, and the way these medical problems are managed might be different from the way they would be managed for someone who does not have dementia.
NPS MedicineWise and Dementia Australia (formerly Alzheimer's Australia) have developed a fact sheet discussing management of other conditions alongside dementia, for people with dementia and their families, friends and carers.
Read our detailed information on other conditions with dementia.
Older people often have more than one health problem and might need a number of medicines each day to control their symptoms or treat their medical conditions. The more medicines you need, the greater your risk of experiencing side effects and medicine interactions. Using multiple medicines of different kinds also makes it more difficult to use them all correctly, and more likely that mistakes will occur.
The way our bodies deal with medicines and the effects medicines have on us changes with age, which can increase the risk of medicine-related problems. Having many health problems at the same time, or being frail, can further increase the risk of problems with medicines.
Find out more about managing medicines as you get older.
If you are living with dementia, you are also at high risk of medicine-related problems due to the effect of dementia on your memory and communication. You may not remember what the doctor or pharmacist said to you about your medicines, or get confused about what the medicines are for or when to take them.1
For these reasons, older people with dementia are particularly likely to experience medicine-related problems. As a person with dementia – or as a family or friend carer – it is vital that you practice good medicine management techniques to minimise this risk.
Good medicine management means taking the right dose of the right medicine at the right time, and avoiding inappropriate or unnecessary use of medicines. You can take steps to practice good medicine management – for yourself or a person you care for – and reduce the risk of medicine-related problems.
It is important to have your medicines reviewed regularly, especially if you are an older person taking multiple medicines. A medicines review can help improve your treatment and prevent medicine-related problems.
On the day of the review, have all the medicines you are taking available for the doctor or pharmacist, including prescription medicines, non-prescription or over-the-counter medicines (such as paracetamol or ibuprofen), and medicines bought at the supermarket or health food store (such as vitamins or supplements).1 If you have an up-to-date list of all of your medicines, show it to the doctor or pharmacist.
When your doctor or pharmacist reviews your medicines, they will gather information about all your medicines, any problems you are having with your medicines, your current health and your treatment goals. Based on this information, your doctor or pharmacist may recommend changes to your medicines (such as stopping a medicine or changing the dose) and work with you to agree on a management plan for your medicines. A medicines review is also a good opportunity to learn more about your medicines and ask any questions you may have.
An up-to-date medicines list is helpful to keep track of all the medicines you are taking and other important information such as what a medicine is for, the dose, when and how to take it, and when you started.
A medicines list is also useful to take to appointments with doctors or other healthcare professionals such as dentists, so that everyone involved in your health care knows all the medicines you are taking. This list also provides vital information about your medicines in the case of an emergency.
When creating a medicines list, it is important that you record all of the medicines you are using including prescription, non-prescription (over-the-counter), vitamins and minerals, herbal and natural medicines. Your doctor or pharmacist can help you create your medicines list or answer any questions you may have.
There are a number of resources available to help you create a medicines list that suits your needs. NPS MedicineWise offers two types of medicines lists:
Find out more about medicines lists and about the MedicineWise app.
Date published : 4 January 2021
Dementia can affect a person’s memory, mood, communication and behaviour. This can make it difficult for a person with dementia to manage their medicines well on their own. Families, friends and carers can use strategies to help the person with dementia take their medicines correctly.1
It is important that you understand your medicines, the associated risks and benefits, and other treatment options available to you. Here are some questions to help you discuss your medicines with your doctor or pharmacist.
For questions about medicines:
For information about where you can get more help, as a family member, friend or carer of a person living with dementia:
Date published : 4 January 2021
Peer support groups for people with dementia can be a good opportunity to share experiences, get support and develop management tools within a social context.
For more information on support groups and/or services in your state or territory call the National Dementia Helpline on 1800 100 500 or see the Dementia Australia website.
Carer support groups provide carers with:
To find a local carer support group contact the local state or territory Dementia Australia office or call My Aged Care on 1800 200 422.
Dementia Australia provides a range of workshops, and information and education courses for people with dementia and their family, friends and carers. A number of these courses and workshops are provided free of charge as they are funded by the Australian Government, however a donation is requested for attendance.
Topics that may be covered in the courses and workshops include:
For more information on training courses and workshops contact the local state or territory Dementia Australia office.
Reasonable care is taken to provide accurate information at the time of creation. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. NPS MedicineWise disclaims all liability (including for negligence) for any loss, damage or injury resulting from reliance on or use of this information. Read our full disclaimer. This website uses cookies. Read our privacy policy.