Understanding Alzheimer's Disease
Alzheimer's disease is a progressive neurological condition that gradually destroys brain cells, leading to memory loss, confusion, and changes in behaviour. It's the most common cause of dementia, affecting over 850,000 people across the UK. The disease disrupts communication between brain cells and eventually causes them to die, resulting in significant brain shrinkage.
Early warning signs include difficulty remembering recent conversations, misplacing items frequently, confusion about time and place, challenges with familiar tasks, and changes in mood or personality. It's important to distinguish between normal age-related memory changes and Alzheimer's symptoms - whilst occasionally forgetting names is normal, consistently struggling with recent memories or getting lost in familiar places warrants attention.
Risk factors include advancing age, family history, and certain genetic factors. If you notice persistent memory problems affecting daily life, consult your GP promptly. Diagnosis typically involves memory assessments, blood tests, and sometimes brain scans to rule out other conditions.
Alzheimer's Medications Available in the UK
Several prescription medications are available through the NHS to help manage Alzheimer's symptoms. These drugs cannot cure the disease but may temporarily slow cognitive decline and improve quality of life for many patients.
Cholinesterase Inhibitors
Three main cholinesterase inhibitors are prescribed for mild to moderate Alzheimer's:
Donepezil (Aricept) - taken once daily, suitable for all stages of the disease
Rivastigmine (Exelon) - available as capsules, liquid, or skin patches for convenient dosing
Galantamine (Reminyl) - extended-release tablets taken twice daily with meals
These medications work by preventing the breakdown of acetylcholine, a chemical messenger important for memory and learning.
NMDA Receptor Antagonist
Memantine (Ebixa) is prescribed for moderate to severe Alzheimer's. It regulates glutamate activity in the brain and can be used alongside cholinesterase inhibitors.
Common side effects may include nausea, diarrhoea, headaches, and dizziness. All medications require prescription from a specialist or GP and are available on the NHS following proper assessment and diagnosis.
Understanding Parkinson's Disease
Parkinson's disease is a progressive neurological condition that primarily affects movement and occurs when nerve cells in the brain gradually break down or die. This degenerative disorder impacts approximately 145,000 people across the UK, with around 18,000 new diagnoses each year.
Motor Symptoms
The four cardinal motor symptoms of Parkinson's disease include tremor (particularly at rest), muscle rigidity, bradykinesia (slowness of movement), and postural instability leading to balance problems. These symptoms typically begin on one side of the body and progress gradually.
Non-Motor Symptoms
Beyond movement difficulties, Parkinson's presents various non-motor symptoms including sleep disturbances, depression, anxiety, cognitive changes, and autonomic dysfunction. These symptoms often appear years before motor symptoms and significantly impact quality of life.
Disease Progression
Parkinson's progresses through five distinct stages, from mild symptoms affecting one side of the body to severe disability requiring full-time care. In the UK, diagnosis typically involves referral to a specialist neurologist or movement disorder specialist following assessment by your GP.
Parkinson's Medications Available in the UK
The NHS provides access to various evidence-based medications for managing Parkinson's symptoms, with treatment plans tailored to individual patient needs and disease stage.
Primary Medications
Levodopa combinations: Co-careldopa (Sinemet) and Co-beneldopa (Madopar) remain the gold standard for symptom control
Dopamine agonists: Ropinirole (Requip), Pramipexole (Mirapexin), and Rotigotine patches (Neupro) mimic dopamine action
MAO-B inhibitors: Selegiline (Eldepryl) and Rasagiline (Azilect) help preserve existing dopamine
COMT inhibitors: Entacapone (Comtess) and Tolcapone (Tasmar) extend levodopa effectiveness
Medication Management
These medications work by replacing lost dopamine or enhancing its effectiveness in the brain. Timing is crucial, as many patients experience motor fluctuations including "wearing-off" periods and dyskinesias. Your specialist will carefully adjust dosing schedules to minimise these complications whilst maximising symptom control throughout the day.
Managing Side Effects and Drug Interactions
Understanding and managing side effects is crucial for successful treatment outcomes. Alzheimer's medications commonly cause gastrointestinal issues including nausea, diarrhoea, and stomach upset, alongside dizziness and headaches. These effects often diminish as the body adjusts to treatment.
Parkinson's medications may produce more complex side effects such as dyskinesia (involuntary movements), visual hallucinations, and impulse control disorders affecting gambling or shopping behaviours. Drug interactions are particularly important to monitor, especially with blood thinners, heart medications, and certain antidepressants.
Contact your GP or specialist immediately if you experience severe side effects, sudden behavioural changes, or concerning symptoms. Gradual dose adjustments under medical supervision help minimise adverse effects whilst maintaining therapeutic benefits. Regular medication reviews ensure optimal treatment balance, and providing clear guidance to caregivers about medication schedules and warning signs supports safe management at home.
Living Well with Treatment and Support Resources
Adhering to prescribed medication regimens is fundamental to slowing disease progression and maintaining quality of life. Consistent timing and proper administration maximise treatment effectiveness. Complementary approaches including regular exercise, cognitive stimulation, and social engagement enhance overall wellbeing alongside medication therapy.
Extensive support networks are available throughout the UK. The Alzheimer's Society and Parkinson's UK provide invaluable resources, local support groups, and specialist guidance. NHS specialist clinics offer comprehensive care coordination, whilst memory cafes and day centres provide social interaction opportunities.
Available Support Services
Carer support programmes and respite care services
Attendance Allowance and Personal Independence Payment benefits
Blue Badge schemes for parking concessions
Local authority care assessments and support packages
Admiral Nurse services for dementia family support
Early planning for future care needs, including Lasting Power of Attorney arrangements and advanced care planning discussions, ensures preferences are respected as conditions progress.
