Donepezil Comparison: How It Stacks Up Against Other Alzheimer's Drugs

When it comes to managing Alzheimer’s disease, Donepezil, a cholinesterase inhibitor used to treat mild to moderate Alzheimer’s symptoms. Also known as Aricept, it’s one of the most prescribed drugs for memory and thinking problems in early-stage dementia. But it’s not the only option. People often wonder: is Donepezil better than rivastigmine? How does it compare to galantamine or memantine? And why do doctors pick one over the other?

Donepezil works by slowing down the breakdown of acetylcholine, a brain chemical that helps with memory and learning. That’s the same basic idea behind rivastigmine and another cholinesterase inhibitor, often used in patch form for easier dosing, and galantamine, which also boosts acetylcholine but works slightly differently by affecting receptors in the brain. Then there’s memantine, a different kind of drug that regulates glutamate, a brain signal linked to nerve cell damage in Alzheimer’s. While Donepezil, rivastigmine, and galantamine all target the same chemical pathway, memantine works on a separate one — which is why doctors sometimes combine them.

People switch between these drugs for different reasons. Donepezil is often chosen because it’s taken just once a day, usually at night. Rivastigmine comes as a patch, which helps if swallowing pills is hard. Galantamine has a shorter half-life, so it needs to be taken twice a day. Memantine doesn’t cause stomach upset as often as the others, but it doesn’t help memory as directly. Side effects like nausea, diarrhea, and dizziness are common with Donepezil and the other cholinesterase inhibitors — but they usually fade after a few weeks. Memantine’s side effects are milder: dizziness, headaches, and sometimes confusion.

What really matters is how well the drug fits the person’s needs. For someone with mild Alzheimer’s and no trouble swallowing pills, Donepezil is a solid first choice. For someone with nausea from other meds, memantine might be added. For caregivers who need simplicity, the rivastigmine patch can be a game-changer. And if memory loss is getting worse despite Donepezil, adding memantine could help slow the decline.

There’s no single best drug for everyone. That’s why so many of the posts here focus on direct comparisons — like how Robaxin stacks up against other muscle relaxants, or how sertraline compares to other antidepressants. The same logic applies to Alzheimer’s meds. You’re not just picking a pill; you’re picking a daily routine, a side effect profile, and a long-term plan. The articles below break down exactly how Donepezil compares to its closest rivals, what real users report, and how doctors decide which one to start with — so you can make a smarter, more informed choice.