Lewy Body Dementia Treatment

Though Lewy body dementia (LBD) is the second most common form of dementia[1] (second only to Alzheimer’s), conventional treatment often fails to improve or soften the symptoms of LBD, and some patients get worse with recommended treatments. If you’ve been diagnosed with LBD, you may have been told ‘there is nothing you can do.’ Well… we disagree!

In a medical environment where medications have become the primary or default treatment for acute and chronic illnesses, patients are often left with little hope. When medicine is used as the only intervention for LBD, individuals often experience a steady decline in both brain and body health. Does this sound familiar? Are you getting physically weaker or do you struggle with parkinsonism? Have you experienced crushing depression or the yoyo-ing brain fog and debilitating confusion? Are you a poor sleeper and experience awful fatigue? If you are a caregiver for someone with LBD, are they experiencing intermittent hallucinations and psychosis? If you answer a resounding “yes” to any of these questions, then we may have some ideas to optimize your approach!

We believe there are many things that can be done to slow the progression of Lewy body dementia, decrease the severity of the symptoms, and improve quality of life. But… (here is the kicker), our clients are taught to think outside of the pharmaceutical box. We coach our clients through many ambitious options that include, but are not limited to, dietary guidance, lifestyle, exercise, sleep, nutritional supplements, brain training and a host of many other brain stimulating interventions that can synergistically strengthen brain function.

When your doctor said there was no treatment for LBD, what may have been a more accurate statement is “there aren’t great medications that treat LBD.” That is an accurate statement! In a recent review of the medical literature, we identified the most ‘up-to-date’ treatment recommendations for Lewy body dementia[i]. They are as follows:

    1. Cholinesterase Inhibitors– These are medications (Aricept[ii], Exelon[iii], etc.) with FDA approval for the treatment of Alzheimer’s dementia. They target the advancing deficit of an essential neurotransmitter called acetylcholine and are designed to slow the breakdown of this neurotransmitter in the brain. Interestingly enough, this class of medicine has shown to be beneficial for certain individuals with LBD, but their effects are typically temporary and vary from person to person[iv].
    2. Memantine (Namenda) is another medication used to slow the progression of dementia, but it also has mixed reviews. Some studies suggested improvement with global symptoms associated with dementia, but not necessarily cognition or psychiatric symptoms[v], [vi] and a few small studies suggested a worsening of delusions or hallucinations with Memantine[vii], [viii]. This is not very encouraging for those with LBD.
    3. When psychiatric symptoms like delusions or hallucinations occur, antipsychotic medications are often ordered. However, the potential for severe side effects (a worsening of Parkinsonism, confusion, autonomic dysfunction, and an increased risk of death) should always be discussed.  Patients and families should be warned about the black box warning the FDA has issued about the use of antipsychotics medications in the elderly with dementia[ix]. Lewy Body Dementia Treatment
    4. Other psychotropic (antidepressants, antianxiety medications) medications can improve symptoms of depression and anxiety in those with dementia. However, once again, you are confronted with the challenges and risk of potential adverse medication reactions when using these types of medications.
    5. Everybody knows that a good night’s sleep can help soften problematic symptoms of chronic illness. This fact certainly applies to LBD and there are many options to enhance sleep, including the use of certain medicines, supplements and lifestyle interventions.
    6. Treatment of parkinsonism in those with Lewy body dementia is similar the treatment in true Parkinson’s disease, though seemingly a little less successful[i].

That’s about it! This about sums up all the anemic considerations that pharmaceutical medicine has to offer (speaking very generally) for those with Lewy body dementia. Unfortunately, the general consensus among the experts is that ‘medications can be poorly tolerated in persons with LBD.’ In fact, the very literature review we summarized suggested that the recommendations offered are only Grade 2C recommendations, meaning they are considered weak recommendations with uncertain benefit and with evidence considered to be low-quality[ii]. The printed recommendations went on to suggest that ‘nonpharmacologic behavioral strategies aimed at modifying stressors in the environment should be employed whenever possible[iii].’  You can read the full treatment recommendations here

Well… we certainly agree with that statement! If the best that pharmaceutical medicine has to offer are weak, uncertain, and low-quality recommendations, then you have nothing to lose when you apply the many nonpharmacological options, interventions, guidance and coaching we offer at A Mind For All Seasons. We integrate the best that both pharmaceutical and natural medicine has to offer. We offer an integrative perspective and have developed an organized, methodical protocol designed to ENHANCE the lives of those with Lewy body and other forms of dementia. Appropriately, we call it The Enhance Protocol®.

We make no promises and we don’t offer treatment guarantees, but we have worked with and coached hundreds of individuals from all across the country. Most of our clients stay with us month after month, a witness of their renewed hope and ongoing satisfaction with our service. Overwhelmingly, our clients note symptom improvements and a greater ability to continue forward when they work with a memory coach at A Mind For All Seasons. Besides your mind and your independence, what do you have to lose?

[i] https://www.ncbi.nlm.nih.gov/pubmed?term=16107351

[ii] https://www.uptodate.com/contents/grade/6?title=Grade%202C&topicKey=NEURO%2F5092

[iii] https://www.uptodate.com/contents/prognosis-and-treatment-of-dementia-with-lewy-bodies/print?search=lewy%20body%20dementia&source=search_result&selectedTitle=2~114&usage_type=default&display_rank=2

[iv] DOI:  10.1002/1099-1166(200009)15:9<794::aid-gps178>3.0.co;2-1

[v] https://www.ncbi.nlm.nih.gov/pubmed?term=24828899

[vi] https://www.ncbi.nlm.nih.gov/pubmed?term=26085043

[vii] https://www.ncbi.nlm.nih.gov/pubmed?term=16087923

[viii] https://www.ncbi.nlm.nih.gov/pubmed?term=16131729

[ix] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516138/