Dan's nursing home called me today about some medication changes for him...it was okay as far as something to help him sleep, no problem with that. Then I was told that their doctor had ordered Exelon for him...since the pharmacy won't cover the patch, he wants him on the generic pill. Quite frankly, I said I disagree with that. He was on the Exelon patch for about 5 years from diagnosis, maybe a couple of months less than that. I know what it is supposed to do, slow down the progress, but at this stage, I just don't think it's necessary. It worked in the beginning, presumably, but would he really be further along than he is without it? If he starts taking it again, it isn't going to reverse anything & I'm not sure at this point that I want to try to slow it down. Besides, since he has pretty much no memory, I don't see it making a difference.
I would say no. We all have a time to make a decision to stop or continue meds that we know does nothing to really help. Plus, we know there are side effects that come along with drugs. Most of the AD drugs cause increased stomach acid, diarrhea, and/or stomach upsets. Is it worth risking upsetting how he is now?
My FIL was never on AD meds until he went into the VA dementia unit after my MIL died. They put him on Namenda. Why I have no idea. If it helped at all it just prolonged the inevitable.
Mim, I discontinued Aricept and Namenda a few years before my husband went into LTC. I didn't think they were helping him and didn't know if any of his minor ailments might be side effects. I also didn't notice any difference in his cognition after they were discontinued.
I had my husband's Aricept discontinued maybe a year before he died. He wasn't eating, and I thought that since Aricept can interfere with digestion, omitting it might help. No change in the appetite, but he became brighter and more talkative. For about 3 months, I had the old Eric back.
100% in agreement with you Mim, once they reach a certain stage with this disease the few medications they could take don't do much to slow the progression down so why have them on it?
My wife is still on Aricept and Namenda, several years now, long past the time when the drugs have been shown to be effective in experimental studies. I've talked with her neurologist about this: it's a small probability that they may be helping, with no obvious downside, so we've continued. I wouldn't add new medication, though; it's hard to see the point of doing that.
RSA, my AD person is still on Aricept & Namenda. Started the Aricept in '07 and the Namenda in '09. So that is 9 years. I agonize over whether to take him off these or not. Will he lose more ability or actually be better? Have heard once they are off the Aricept, they cannot regain ground lost, but the first nursing home he was in did exactly that, and he went way backwards, and regained it when it was restarted. His Dr. said they had never seen anyone get such great effect from Aricept. I'd like to hear more experiences. At this point I question them continuing his blood thinner and seizure medication - the blood thinner was given after he got a blood clot from Seroquel & Depakote, both of which he had bad reactions to & is no longer taking. (Can't ever take again either). The seizure was thought to have occurred when a nurse at the nursing home withheld his Ativan for 4 days. I do question these continuing, although I know some AD patients do get seizures. 9 years into the disease, what helps the most still is the Ativan, which we still have to fight the insurance company for since it isn't indicated for the disease.
mariposa, my wife is also on anti-seizure meds. After surgery to remove her brain tumors in 2007, she developed epilepsy, but she hasn't had a seizure for several years now. My wife's condition isn't really directly relevant to AD, because her dementia was brought about later by radiation.
But I'm glad that your AD person has responded so well to Aricept! I always keep in mind that when it comes to some medications, where the mechanism by which they work isn't well understood, clinical studies can only tell us whether the medication will be effective on average, for some population of people. That leaves open the possibility that it may work much better than we expect for some people (and maybe not at all for others).