My husband was diagnosed in July of 2008 with probably Alzheimer's Disease. I'm guessing he is between stages 4 and 5. He started on Namenda in July and he seemed to respond to it and seemed to be more stable. It may be crazy but I did not see so many swings up and down. He was started on Aricept about 6 weeks ago. His neurologist gave me 1 month of sample pills. My insurance company denied it and I wasn't able to get his next set of samples to carry over until I filed an appeal. As a result he was off Aricept for 1 week. I didn't think it was making any difference but after he was off for 3 or 4 days, I noticed more frequent memory lapses and he didn't seemed to be depressed as much. We got more samples and memory seems to be more level but he seems to be more depressed, more swings up and down and primarily down. Is this a side effect of Aricept or Namenda & Aricept?
I don't know if it is a side effect per se, but my DH was very depressed last year when his memory was better. Now that his memory has degraded to the point that he does not remember he's sick (he thinks he's fine), his active depression has eased. He is still on Celexa, so that is helping. But my point is that if Aricept is helping your DH remember that he is sick, it could have the effect of enabling him to be depressed. Perverse, I know, but it's a thought that may hold water.
Does that mean you should take him off? That's a hard question. If it is helping him enough to enable him to be depressed, that also means he is more "here" with Aricept and more able to participate in life.
That's a tough one isn't it...B. was on just Namenda, then neurologist prescribed namenda and aricept. I thought the combo was making him worse...took him off the aricept to see if it made a difference. It didn't. He just seems to be on a decline. Now I'm wondering if the Namenda is doing him any good.
I am thinking about taking him off of that for a week or so and see if there are any noticeable changes. I don't think he needs to take it if it's not making any difference (which I suspect it isn't).
Diane T. I know what you mean about the depression/memory conundrum. Since B. has been on Namenda I have noticed he seems to be more aware of his confusion. That's not good.
Mine is on Razadyne and Namenda and has not been in a depression, thank goodness. I really think it is both together that MIGHT be working to keep them from slipping into stage 7 faster.
I've heard several here that have had to take their husbands off of Aricept and switch to Razadyne due to side effects. You might want to check with your doctor.
My husband had some depression last November. Now he is pretty happy most of the time. I think he was either late stage 4 in November or early stage 5. He is now early stage 6 and just at the border of Profoundly Demented on the mini-mental test. So basically, last November he had a clue as to what was wrong with him, and now, he doesn't have a clue.
If I had recognized that the change in personality was depression back then and/or if I had been on this forum with its wealth of knowledge, I'd have gotten him on an anti-anxiety or anti-depression medication. He doesn't need one of those now but if he starts getting agitated as he moves through stage 6 I'll get him onto something at that time.
He was already on Razadyne and had just started Namenda, but I don't think those drugs were the cause. It is possible that the improvement in cognitive functions those drugs made possible were enough for him to recognize just how sick he was.
So now I'm wondering is depression is one of those indicators that moves you from one stage to another. I can talk with DH's neurologist and try to figure out what the best course is. Thank you for your posts.
Aricept can cause depression, although it's fairly uncommon. If you're going to play around with his meds, consider switching to Razadyne. Reportedly, the generic version will be released soon, maybe December. Save mucho dinero.
Oh ... and I don't think you're wrong about the namenda. My husband improved significantly when he was put on that, and I know other caregivers whose ADLOs also responded very positively.
I've notice on a lot of posts that spouses seem to monitor or change their LO's medications. I would think that the doctors know best based on what you have observed. I can also see that they don't know your LO like you do. I will as about Razadyne but how do you really know what they should be on OR whether the side effects are worse than what they are like when then aren't on any drugs. Sometimes these symptoms are so subtle yet they just wear on you every day, little by little.
Side effects is a guessing game. And unless your spouse responds quickly and positively, so is trying to tell whether the medicine is helping. Much of medicating an AD patient is trial and error.
Good doctors, ones who are very experienced in AD, probably know best, but they will also involve the caregiver intimately in making decisions, since only the caregiver really knows how the AD patient is behaving. Unfortunately, the truly qualified doctors are few and far between.
I agree that we talk about drugs and say, well try this or that. The truth is that nothing seems to work for every person, and that the doctors appear to have very little clue as to what will work with a given set of symptoms. If you go back through the messages you'll find people who swear by seroquel, and those who found it zonked their husbands out; those who know about gabapentin (neurontin) and those who don't. There are so many drugs out there, and the doctors see your person once every six months and more or less say try this, it's a nice red pill, and if that doesn't work I'll give you a blue one.
There are too many meds, and no, the doctors do NOT know what is going on with a given person. Particularly early on, when they don't know your spouse or you very well, they'll talk to the spouse, who gives them of course a completely erroneous idea of what's going on, or they'll find YOU an unreliable witness to his activities, so they're pretty much blindly prescribing.
You will find here a healthy cynicism about doctors' infaillability!
Exelon patach since last November. Namenda since last May. I've not noticed any depression but memory does seem to be declining quite a bit the last couple of weeks.
My husband has been on Aricept since he was dx'd last September. So far he has not had any problems. He saw his neuro yesterday and he is still in the mild stage. I wonder sometimes how long he will stay in this stage I kind of thought he would have some other symptoms by now and not just short term memory. That can get annoying too when you have to keep repeating yourself.
Jean, Starling's husband was helped some by cognitive training at a stroke rehab center. Techniques such as "spaced retrieval" has been shown to be helpful in improving memory in people with MCI and mild AD. Maybe your husband would have some success with that... and relieve the stress on you.
I just thought to myself, I am going to check the forum to see if anyone has any thoughts on these common dementia meds and as always there is a wealth of info and discussion! We all have so much to think about with this disease and the accompaning ambiguity. My husband was dx'd in April of 2006 when he was 56 and now two and a half years later the disease is progressing so rapidly, that it is hard to keep up with the changes. He has had so many areas of decline, including being unable to stand unless prompted, needs cueing to eat, totally incontinent and most recently started just making nonsensical noises most of the time. He has taken Aricept and Namenda from the get-go (in addition to Seroquel and recently they added Requip to counteract the rigidity caused by the anti-psychotic). He is becoming very resistant to taking pills and I am tempted to drop the Aricept and Namenda. Does anyone have quantitave proof that these meds are doing anything? The neurologist and the psychiatrist along with his family doctor seem as mystified as I am regarding the benefits of these meds.
Beth, I am so very sorry your husband is declining so quickly. I know that is very, very hard on you. You have my heartfelt sympathy.
Your question is one that is raised all of the time. There is some evidence that, on average, these meds can work for at least four years (the longest period of time that has been tested so far). It's hard to tell how much good they can do without a large clinical trial that makes it possible to compare large numbers of medicated patients against unmedicated controls, so they can do statistical analyses, since patients progress at such widely different rates. On average, they're still working.
But that is only ON AVERAGE. What works for your husband is what works for your husband. Some patients have actually started developing adverse side effects, and improve (sometimes a lot) if taken off one or both. Some patients are taken off because the meds don't seem to be helping, and they go into a steep nosedive. Some patients don't change at all when taken off.
All you can do is decide what you want to try. If you think the AD meds aren't doing much, cut back a little on one for a while to see what happens, and take it from there.
Thank you so much for your kind thoughts and empathy. It means a lot to know that there are caring people who truly understand the struggles. I also thank you for your feedback. I must not be thinking clearly! Of course the best way to approach the situation is to just let one of the meds go at a time and see if there is any noticeable change..........I better start keeping a diary to help me keep track.
Starling, I don't think my husband would try anything other than what he is already doing. He thinks at 80 years old there isn't much point in trying anything else. Of course he also thinks he is doing okay and will not get in the end stages. As I said once before...he became clairvoyant when he got AZ!!!!!!
I really only think that cognitive therapy will work in two situations. The patient is in an early stage. The patient is MOTIVATED to do something for themselves.
My husband wasn't at an early enough stage. The therapist is the person who actually diagnosed him and kept insisting he needed to see a neurologist until he finally gave in. He might have been motivated enough, but he really no longer could learn new things, so it just did not work.