Treatments for dementia: the complete picture

Medication: what is and is not available

For Alzheimer's Disease (and Mixed dementia)

• Cholinesterase Inhibitors: Donepezil, Galantamine, Rivastigmine. Licensed for mild to moderate Alzheimer's Disease under NICE TA217. About 60 per cent of people who tolerate them experience meaningful improvement.
• Memantine: licensed for moderate to severe Alzheimer's Disease and as an add-on to a Cholinesterase Inhibitor.
• Lecanemab and Donanemab: anti-amyloid antibody infusions, currently not recommended by NICE for routine NHS use (June 2025).

For Vascular Dementia

Cholinesterase Inhibitors are not recommended for pure Vascular Dementia. The mainstay is aggressive vascular risk reduction: blood pressure control, lipid management, diabetes control, smoking cessation, alcohol reduction, and antithrombotic medication where indicated.

For Dementia with Lewy Bodies

Cholinesterase Inhibitors (particularly Rivastigmine and Donepezil) often produce meaningful benefit. Memantine may help in moderate to severe stages. Antipsychotics are contraindicated or used with extreme caution.

For Frontotemporal Dementia

No medication slows Frontotemporal Dementia. Symptomatic treatment uses Selective Serotonin Reuptake Inhibitors for behavioural symptoms. Cholinesterase Inhibitors are not recommended.

Non-pharmacological treatments

Non-pharmacological treatments are not "alternative" treatments; they are core. NICE NG97 specifically recommends Cognitive Stimulation Therapy for cognitive symptoms in mild to moderate dementia. Other evidence-based options include:

• Reminiscence Therapy: uses memories, photographs and music to support engagement.
• Validation Therapy: communication approach that prioritises emotional truth over factual correction.
• Music and arts therapies: among the strongest non-pharmacological interventions for mood and engagement.
• Aromatherapy: lavender and lemon balm for agitation.
• Pet therapy: animal-assisted interventions for mood and engagement.
• Mindfulness: for both patients (in mild dementia) and carers.

Behavioural and psychological symptoms

The Behavioural and Psychological Symptoms of Dementia (BPSD, ICD-11 6D86) often respond well to non-pharmacological approaches. Where medication is needed, the framework is set out on the agitation and aggression page and on the antipsychotic prescribing page.

Clinical trials

Several disease-modifying approaches are in active trials in the UK. The clinical trials page sets out how to find studies and how to register your interest through Join Dementia Research.

Where The Dementia Service fits in

The Dementia Service assesses, diagnoses, and initiates and reviews anti-dementia medication directly where clinically appropriate, and signposts to local non-pharmacological options, with no GP referral needed. Where appropriate, the service can also discuss eligibility for clinical trials.