In plain English
Dementia treatment combines medication where appropriate with non-pharmacological therapies, lifestyle measures and structured support. This section sets out every UK-licensed medicine and the evidence-based non-medication options recommended by NICE.
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 initiates and reviews anti-dementia medication, signposts to local non-pharmacological options, and writes to your GP for shared-care prescribing. Where appropriate, the service can also discuss eligibility for clinical trials.
Frequently asked questions
Is there a cure for dementia?
No cure for the common neurodegenerative dementias today. Cholinesterase Inhibitors and Memantine help symptoms in many people. Anti-amyloid antibodies (Lecanemab, Donanemab) modestly slow decline in early Alzheimer's Disease but are not currently recommended on the NHS.
Do non-pharmacological treatments really work?
Yes. Cognitive Stimulation Therapy has an effect size similar to Cholinesterase Inhibitors. Music, exercise, social engagement and structured routines all have evidence for improving mood, behaviour and quality of life.
Which treatments combine?
Cholinesterase Inhibitors and Memantine can be combined in moderate to severe Alzheimer's Disease. Both can be paired with Cognitive Stimulation Therapy, vascular risk reduction and lifestyle measures. Antidepressants can be added where mood symptoms are present.
Are antipsychotics ever used?
Rarely, and only when severe behavioural symptoms threaten safety despite non-pharmacological measures. Risperidone is the only antipsychotic licensed in the UK for short-term treatment of persistent aggression in Alzheimer's Disease.
How do I find a clinical trial?
Register with Join Dementia Research at joindementiaresearch.nihr.ac.uk. Your memory clinic or GP can also signpost.
References
- NICE TA217: Donepezil, Galantamine, Rivastigmine and Memantine for Alzheimer's Disease.
- NICE NG97: Dementia, assessment, management and support.
- NICE GID-TA11220 and GID-TA11221: Lecanemab and Donanemab appraisals.
- British National Formulary. Dementia drug entries.