Few options. There are currently no fda-approved treatments specific for lewy body dementia (dlb). But given the severe cholinergic losses that occur in dlb, the frequent co-occurrence of alzheimer's disease pathology, and several small trials that suggest their effectiveness, cholinesterase inhibitors are the off-label treatment of choice. Exelon (rivastigmine) patch has shown some effectiveness for the cognitive decline.
Meds & Support!! Dopamine meds for physical parkinsonism: Azilect (mao-b selective inhibitor) & sinemet +/- Comtan (stalevo (carbidopa and levodopa and entacapone) is both together). Tailor rx watching for side effects. Avoid Dopamine agonists (requip xl/mirapex er/neupro)--too side effect prone for lewy body patients. For dementia: namenda, paired with Exelon patch or aricept. For psychosis: seroquel or even clozaril. For excess sleepiness: nuvigil.
Symptomatic therapy. Just like many other causes of primary dementias, there is no definitive therapy or cure. However, some medications like donepezil and rivastigmine can help with the memory loss by slowing down the rate of progression of symptoms and allowing patients to maintain certain level of cognitive function for a longer period of time. They also help with some of the behavioral features. Read more...