Medications

Medications

Common LBD and PDD Medications Reference List:

  • Consult your doctor before taking any medication. 
  • Certain medications may worsen LBD symptoms or cause severe side effects.

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

Trazadone (requires Rx): for sleep

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

  • 6mg pill 2x/day (the pill works better than the patch)

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

  • lower doses are more effective

Aricept/Donepezil, Namenda/Memantine (require Rx): for cognition-enhancing

Seroquel/Quetiapine (require Rx): for LBD psychosis

Nuplazid/Pimavanserin (require Rx): for PDD psychosis

  • reduces hallucinations without disrupting motor ability

Sinemet/Carbidopa Levodopa (require Rx): for Parkinson’s/movement issues 

  • higher doses can increase psychosis

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

Myrbetriq (requires Rx): for incontinence 

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

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

Other OTC Medications that might be helpful: Consult your doctor.

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

Please note:

**Benzodiazepines are NOT recommended for LBD. 

  • They are used for sedation, anxiety, sleep, muscle spasms, and seizures.
  • Can cause aggression or agitation
  • Clonazepam/Klonopin and Alprazolam/Xanax are benzodiazepines 
  • (prolonged use can cause a rebound effect)

Levodopa medications are preferred over dopamine medications for Parkinson symptoms
because dopamine is not tolerated well in LBD. 

Paxlovid (oral, antiviral pill for Covid symptoms) – not recommended, does not interact 
well with quetiapine/Seroquel

Gabapentin (for nerve pain or seizures) is not recommended for LBD. It can make psychosis worse.

Wellbutrin is not recommended for LBD. It can increase anxiety.

Use caution with OTC cold and allergy medications as they can increase agitation, 
hallucinations, and sleep issues.

Anticholinergic Reference Sheet