Medications

IMPORTANT REMINDERS:
Carry an LBD medical alert wallet card from LBDA.org
– Consult your doctor before taking any medication. 
– Certain medications may worsen LBD symptoms or cause severe side effects.

Common LBD and PDD Rx Medications:

Seroquel/quetiapine (require Rx): for LBD psychosis

Exelon/rivastigmine (require Rx): for Rem Behavior Disorder (RBD) and cognition

  • 6mg pill 2x/day (pill form may work better than the patch)

Remeron/mirtazapine (require Rx): for depression and RBD sleep issues 

  • lower doses may be more effective

Aricept/donepezil, Namenda/memantine (require Rx): for cognition-enhancing

Nuplazid/pimavanserin (require Rx): for PDD psychosis 

  • reduces hallucinations and delusions without disrupting motor ability

Sinemet/carbidopa-levodopa (require Rx): for PDD movement issues 

  • higher doses can increase psychosis

Zonegran/zonisamide (require Rx): used with levodopa for PDD motor issues

Myrbetriq (requires Rx): for incontinence 

Gemtesa (requires Rx): for incontinence

Trazadone (requires Rx): for sleep and depression

Cymbalta (requires Rx): for mood, depression, anxiety 

Lexipro/escitalopram (require Rx): for depression and anxiety

Zoloft/sertraline (require Rx): for depression, mood, anxiety, and agitation

Common LBD OTC Medications : Consult your doctor first.

Melatonin (OTC): for sleep (5mg) and sundowning (10mg)

Natrol (OTC): time released melatonin gummies for sleep (5 or 10 mg)

Claritin (OTC): for allergies

MiraLAX (OTC): for constipation

Senokot (OTC): for constipation

Magnesium (OTC): for constipation, sleep, and muscle contractions

**OTC cold/allergy medications can cause sleep issues, agitation, and hallucinations.

Medications NOT Recommended for LBD

Haldol (haloperidol) and Risperdal (risperidone): NO  

  • Both are antipsychotics that can cause severe, adverse, possibly fatal reactions.

Benzodiazepines NO

  • Used for sedation, anxiety, sleep, muscle spasms, and seizures.
  • Can cause aggression or agitation
  • Xanax/alprazolam, Ativan/lorazepam, Klonopin/clonazepam are benzodiazepines (prolonged use can cause a rebound effect)

Benadryl: NO

  • An OTC cold/allergy medicine that can cause severe sleepiness, hallucinations, and cognitive impairment.

**These drugs should be added to your allergy list on all online medical records.

Other Rx medications with possible contraindications:

Paxlovid (oral, antiviral pill for Covid symptoms) – may cause adverse reaction when taken with Seroquel/quetiapine. For severe Covid symptoms, Seroquel dosage should be reduced or stopped while taking Paxlovid.

Gabapentin (for sleep and anxiety) – low doses only – higher doses can increase psychosis

Neudexta (for agitation) – sometimes used off-label with cautions

Wellbutrin (atypical antidepressant) – may increase confusion and anxiety

Download the Anticholinergic Pocket Reference Card here.