donepezil help

[Jilly1]

Hi,
My husband has been taking the 10mg tablets for about two weeks now and he had been told to take the 5mg in the morning as it disturbed his sleep. When he took the higher dose we continued him taking it in the morning but it made him feel unwell. He said he felt shaky on his legs. So, we switched it back to taking it at night and last night he was unwell again while laying in bed. Is there an alternative drug out there we can try. When I asked the Memory clinic nurse what happened if this drug didn't work was there another we could try she said no. I am not quite sure how he feels but the fact he says he feels funny tells me a lot as he isn't one to complain.

 

[Tinkerbelle258]

Hi,
My husband has been taking this for nearly a year now. In the first few weeks he did have some side effects but he persevered and they gradually stopped. By trial and error we found the best time for him to take it is around 6pm after his evening meal. This way it is late enough in the day not to interfere with his daily routine but early enough so that he is not going to go straight to sleep. This seemed to prevent the bad dreams and nightmares.
However, what I really wanted to say was that when he was first prescribed this we were told that if it didn't suit there were others to try. I am sure that there will be others along soon with names of some of them.

 

[Izzy]

My husband was on Donepizil (Aricept) for about 10 years. When the thought he was no longer gaining benefit from it they switched it to Rivastigmine (Exelon). They are both the same family f drugs - anticholinasterase inhibitors (not sure about spelling!).

This is the societ's factsheet on treatments.

http://www.alzheimers.org.uk/site/scripts/download.php?fileID=1760

 

[Nebiroth]

Yes, if the patient cannot tolerate donepezil it should be possible to try one of the two alternatives; these drugs work in a similar way but are different enough that a person intolerant to one may be able to take another.

Donepezil - Aricept - is almost always the drug of first choice because of the three it is regartded as being the least likely to have side-effects and it is also the cheapest (which does not mean it is less effective, only that the others are more difficult to make)

One of the alternative drugs, called Exelon (Rivastigmine) is also available in a patch form. This can be helpful as it delivers the drug throughout the day in a low steady dose, whereas tablets tend to result in a dose that fluctuates somewhat between taking them. It is also helpful is the patient finds swallowing tablets impossible.

I do not know why the nurse has said there are no alternatives that can be tried, because there are.

Be aware that if you have to switch drugs, there will be an interim period between stopping the donepezil and starting the new drug. This is because the donepezil must completely clear from the body before starting the new drug. This can take several days at least, and sometimes patients are told to wait a week or more to make certain.

 

[Jilly1]

Thanks for your replies. Saw the doctor this morning and he has put Geoff back on to the 5mg tablets. When I asked about alternatives he said they all had the same side effects and didn't offer to try anything different. He also said he would contact the nurse involved (oh deep joy) so we will see if she contacts us.
I have gone on the link you supplied Izzy and have printed it off so if the nurse visits again I am fully armed!! At least I can ask about them!
I think the nurse and I got off on the wrong foot before because I asked (in my own home) if she minded if I smoked and she replied 'if you really must' . As I was getting into a state I lit one! I know I shouldn't smoke but right now I am using them as my only crutch!
Thank you all again for your valuable help.