Aricept Versus Reminyl?

[ash-hello]

Hello everyone

This is my second post. Could anyone give me some advice on AD medication please? My (mid-60's) mother has just began Reminyl as she is in the early stages of AD. However, having had a brief look into research findings of AD medication, Aricept 'appears' to be more effective and better tolerated than Reminyl. As I am not a doctor, I am not sure why my mother's consultant favours one against the other. However, I got the feeling from what my mother's therapist said, that Reminyl was the consultant's standard choice.

- Do I have the right to ask why Reminyl is being prescribed?
- Do I have the right to ask for my mother to be given Aricept?
- Does my mother have legal rights to any AD drug at this stage?

I realise that medication is an emotive subject and some may even say avoid it, but where there is hope..............

Thank you for your help.

 

[jenniferpa]

Hmm. Have you seen this factsheet http://www.alzheimers.org.uk/factsheet/478 ?

I'm sort of surprised that with these guideline that your mother is getting any kind of prescription if she is, as you say, at the early stages (pleased but surprised). I have no idea of the relative costs for these drugs in the UK but perhaps reminyl is the least expensive (that appears to be true in the US) so maybe that's why. I think you have a right to ask why this drug, you could even ask for a different one, but you do not have a legal right to receive a drug even if you ask for it. I would keep a close eye out for side effects.

 

[Nebiroth]

I believe that Aricept is generally reagrded as being the best tolerated (ie it has the least chance of producing unwanted side effects). I don;t know about cost. The prescriber may eithe rhave a personal preference or there may be some clinical factor, for example, my father was changed from Aricept to Reminyl because the consultant felt that Reminyl was more beneficial with patients who had psychotic symptoms.

You certainly have the right to ask any questions you see fit! It might be beneficial to ask the prescriber why they felt that Reminyl was more suitable than Aricept.

I think it;s good that your mother has received anything, as the NICE guidelines mean patients in the early stages don;t qualify, although I believe that it is still possible for doctors to prescribe them if they feel there is the clinical need to do so. Although they may have to justify this to their Primary Care Trust.

 

[ash-hello]

Thank You

Thank you both for your replies. From the gist of your replies it does seem that my mother is 'lucky' to be receiving any medication at this point, therefore I don't really want to rock the boat regarding Aricept etc. She did get the required scores during the assessment to be given Reminyl, but sadly, I am beginning to get the feeling that she is further along the AD path than the mental health visitor is admitting.

 

[gigi]

Hello Ash,

My husband has been on Reminyl for 2 years now..no side effects..and I am grateful for it.

Although without it I haven't a clue how he would be. He is slowly deteriorating in spite of medication..which
I understand happens...

am beginning to get the feeling that she is further along the AD path than the mental health visitor is admitting.

I've been through this..and wouldn't worry about it. People who visit for a short while only see what they see in that brief moment of time. Your perception will be different if you spend more time with your mum..also you know her better and are more sensitive to change.

If your mum is on medication she should have at least a 6 monthly review with the consultant..

If you feel that her deterioration is rapid ..or her safety or health is at risk..then contact the consultant and ask for an emergency review...

Wishing you both well...your mum is lucky to have you to care ...

Love gigi xx

 

[ash-hello]

Thank you for your kind words

Thank you Gigi for your kind words. It is reassuring to hear from someone who has some close-hand experience of Reminyl, although I realise that everyone is different on it. Since starting the drug my mother does seem to be worse infact, more anxious and confused. It is hard to know whether this in itself is a side-effect until the medication settles down. Everything is an unknown at this point (I can't even begin to think of the difficulties that lie ahead....).

 

[Skye]

Hi Ash

My husband John was also prescribed Reminyl, and did very well on it, his deterioration was very slow for seven years, then he nose-dived. I'm convinced the drug kept him going for so long. He had no adverse side effects.

I was advised to ask for Reminyl rather then Aricept because Reminul has an extra ingredient.

All three drugs currently available for Alzheimer's disease aim to affect this cycle by preventing the breakdown of acetylcholine so that there is more available in the brain to carry messages between the brain cells. Reminyl also affects another part of the cycle, which causes a greater release of acetylcholine

There's really very little difference in cost, Aricept £1160 per year, Reminyl £1095, Exelon £886.


You certainly have the right to ask questions, and I hope the consultant would encourage this. You should also keep a note of any adverse effects, and ask for a review if you are worried at any time.

As you say your mother is within the range for prescription, I think you may be right that she is further along than you thought. The mmse test is scored out of 30, and drugs are only supposed to be prescribed when the score drops to 20.

I think you're right to let your mum try the medication, but perhaps you could keepa diary to monitor her progress?

Love,

 

[p34nut5]

Hi Ash,

My mum tried Aricept to begin with - it's a long story but she was taken off it without giving it a proper chance to work. However, she's on Reminyl now ( has been for about 6 weeks) and I think it really is helping ie when she's having a good day, she does seem to be able to remember things relatively clearly which is great to witness.

I think Reminyl is good so I wouldn't worry too much - Also you could always ask the consultant to transfer to Aricept if you feel Reminyl isn't working/has side-effects.

Fingers crossed for you.

Sue

 

[gigi]

[The mmse test is scored out of 30, and drugs are only supposed to be prescribed when the score drops to 20.
/QUOTE]

Eric (my husband)...must have sneaked in just as the guidelines were changing..he has always..since diagnosis..scored between 26/29....

Even though physically and mentally he is deteriorating...

Ash...I don't know how long your mum has been on Reminyl....but you do mention increased anxiety and confusion..

This may be a side effect of the drug...if it does not settle then you must refer back to the consultant.

Love gigi xx

 

[citybythesea]

Ash,

Here is a very good overview on the treatment of dimentia in general....also remember that this is from a US site, so guidelines are different on what can be given as we are a self paying country.

http://www.webmd.com/alzheimers/tc/dementia-treatment-overview

HUGS

Nancy

 

[janjan]

Hi Ash, When my dad was diagnosed 5 yrs ago, he had got to the stage that he couldn't understand what the difference the drugs was or how they worked. So at this point i felt that i had the right to ask what drugs he was being given as i feel he would have expected me to for him.
I also caused a stink when i found he was on a dangerous drug for someone with L.B.D and Parkinson's.
I don't mean to sound hard, and things wasn't easy to sort out but we sorted it in the end. Dad as been in a N/home 2 yrs and is in good health for someone at the end stage.

 

[ash-hello]

Thank You For Your Advice

Hello everyone

Thank you very much for all your replies and words of support. I feel that getting my mother on to Reminyl at least gives her a fighting chance and your comments have reinforced this view. She will be having her dose upped again soon (so I am told) and hopefully this will, maybe, show some visible improvements in her memory and mood. Best wishes to you all Ash