Aricept side effects & depression

chinwag

Registered User
Oct 1, 2009
8
0
South Yorks
Hello everyone :)
My Dad is 73 was diagnosed with AD a few months ago although we'd suspected it for a couple of years. He's currently taking Aricept and uses Butrans patches for arthritis of the spine. He started them both at about the same time and since then has lost two stone (along with his appetite) and has trouble sleeping. I've read that loss of appetite and insomnia can be side effects of Aricept but he's had a gastroscopy and colonoscopy and is now down for a ct scan for possible prostrate cancer. He's still in a lot of pain with his back and as you can imagine he's getting quite depressed.

On a side note he and Mum were told at the memory clinic that they were happy for him to continue driving if Mum was happy with it. She was, so they filled in the forms and forgot about it. When they heard back from the DVLA the Dr at the memory clinic (whose wife had just gone into labour when he saw Dad and had neglected to put the notes in Dad's file) had informed them that Dad had agreed to stop driving so Dad's licence had been cancelled. Mum and Dad spoke to this Dr who insisted Dad had agreed to it which was untrue as Mum was there too but said they couldn't do anything about it now unless Dad's condition improved.:mad: This happened a week before we went on a family holiday in the UK and he and Mum had to get the train because his licence had been cancelled so quickly. He's scared to appeal because he doesn't want to do a test and I think this has upset him more than anything.

Anyway I wondered if others had experienced side effects with Aricept and what's the best way to deal with his depression? Dad was on amitriptyline until he started the Aricept and I wondered if other antidepressants can be used with Aricept or do they interfere with it's effectiveness?

Sorry for going on so. I've just had him on the phone talking about not wanting to live much longer and although I know he'll calm down in a little while it's still difficult to hear without wanting to do something. (He's not on his own btw. Mum's with him and I go round when she goes out).
 

Izzy

Volunteer Moderator
Aug 31, 2003
74,389
0
72
Dundee
Hi there! My husband, Bill, has been on Aricept for 9 years now. I would say that his appetite has decreased over this time. He tends to eat a lot of small sweet bits through the day (when I'm at work) and then doesn't always finish his meal at night. For most of the 9 years he has also taken Citalopram for depression. I find it hard to say if it made much difference, I don't tend to think so. Last week the doctors changed his depression medication to Mirtazapine(Zispin). I think his appetite has improved a bit but I think he has become very very sleepy. I think it must be connected to the change in medication. Doc has said it might take time for him to get used to it so we'll see what happens. They only changed his medication when I wrote to the doctor at the memory clinic and said I wasn't too happy with the 9 years of 6 monthly 10 minute appointments when basically all that happened was that he got his Aricept prescription. Since then he has been going to a day hospital one day a week for assessment and it was through this that the change in depression medication was suggested. Not sure that's much help to you but it's just my experience. Take care. Izzy x
 

Sandy

Registered User
Mar 23, 2005
6,847
0
Hi Chinwag (great name),

Welcome to Talking Point (TP).

Given all your father's health issues, I think the possible side effects of Aricept is really something for the medics. My mother-in-law has been on Aricept for 15 months now, but showed no side effects. Other people have reported quite strong gastro-intestinal side effects. In some of those cases, people were moved onto Exelon which is available as a patch:

http://www.alzheimers.org.uk/factsheet/440

Do you and your mother feel that the Aricept has helped with any of your father's symptoms? It can take quite a few weeks to really kick in. In my MIL's case, it did greatly relieve her anxiety and paranoid delusions and generally lifted her mood.

It is not at all uncommon for people to be on dementia medication like Aricept and an anti-depressant of some kind:

http://www.alzheimers.org.uk/factsheet/444

Is your father being monitored by a CPN (Community Psychiatric Nurse)? I would try and raise the subject with him/her.

Driving is a common issue on TP. I'll just mention that the Society has two good resources on this topic:

http://www.alzheimers.org.uk/factsheet/439

http://www.alzheimers.org.uk/site/scripts/download_info.php?downloadID=147&fileID=729

Here is the process for applying to drive again after voluntary surrender, if your family decides to go that way:

http://www.direct.gov.uk/en/Motoring/DriverLicensing/MedicalRulesForDrivers/DG_4022414

It is a difficult issue and it is never easy to decide when to give up driving. One possible alternative would be for your dad to go to one driving assessment centres (privately run) and have an independent assessment of his driving skills:

http://www.mobility-centres.org.uk/services/drivingassessment.htm

Take care,
 

chinwag

Registered User
Oct 1, 2009
8
0
South Yorks
Thanks for your reply Izzy. Wow nine years is a long time. Gives me a little hope.:)

I hope the Mirtazapine works well for Bill. Did he have any problems switching from the Citalopram?

I may suggest Mum and Dad go back to their GP. Atm Dad is on a sleeping tablet every other night to help him sleep which of course means he sleeps every other night.:rolleyes:

I sometimes think I'm getting obsessed with the practical details to stop me having to really think about what is happening to him. Sooner or later I will have to accept that I can't 'fix' him no matter how much I want to. Oh well.
 

Izzy

Volunteer Moderator
Aug 31, 2003
74,389
0
72
Dundee
I hope the Mirtazapine works well for Bill. Did he have any problems switching from the Citalopram?

I sometimes think I'm getting obsessed with the practical details to stop me having to really think about what is happening to him. Sooner or later I will have to accept that I can't 'fix' him no matter how much I want to. Oh well.

I think only the excess of sleepiness at present!!

I think you're right there. I eventually got round to going along with the flow - can't change things so have to make the best of them.

Take care. Izzy x
 

Nebiroth

Registered User
Aug 20, 2006
3,510
0
Sad to say, I think that some people with dementia become depressed when they start Aricept because they gain more insight into their condition. The improvement some people get in their faculties is just enough for them to realise how those faculties are failing - in short, they improve just enough to be able to recognise how bad they are and what the future will bring.

It is possibly the only small mercy in dementia, that the person who has it loses the ability to have insight into their own condition, often believing there is nothing wrong with them. This makes it much harder on the caring side, but eases the burden on the sufferer to a degree. It would be much more terrifying to know with full clarity how bad one has become, and that it can only get worse.
 

Sandy

Registered User
Mar 23, 2005
6,847
0
Hi chinwag,

I sometimes think I'm getting obsessed with the practical details to stop me having to really think about what is happening to him. Sooner or later I will have to accept that I can't 'fix' him no matter how much I want to. Oh well.

That is a really valuable insight to have at this stage.

I tend to want to be a 'fixer' also. But each contribution that you can make to helping your parents live with such a challenging condition is 'a fix' of a kind - albeit maybe a short-term one, until the next issue arrives.

It's a bit like the reverse of learning to ride a bicycle. At first you're running alongside, then providing the stability of two small wheels either side, etc. - allowing them to keep moving along, in control as much as possible, for as long as possible.

Take care,
 

chinwag

Registered User
Oct 1, 2009
8
0
South Yorks
Hi Sandy

Thanks for the reply.

Dad goes back to the memory clinic next month so I may suggest they talk to them about possible side effects and alternative treatments if the physical tests don't show anything. I'd be wary of the patches though as he's become allergic to the butrans patches.

Do you and your mother feel that the Aricept has helped with any of your father's symptoms?

I think he has improved somewhat. His driving certainly improved but recently he's been getting depressed and moody which makes it more difficult to tell.

Is your father being monitored by a CPN (Community Psychiatric Nurse)? I would try and raise the subject with him/her.

No he isn't. Would Mum ask the memory clinic or their GP about this?

It is a difficult issue and it is never easy to decide when to give up driving. One possible alternative would be for your dad to go to one driving assessment centres (privately run) and have an independent assessment of his driving skills:

To be honest I think it may be best if he calls it a day now that it's happened but we had planned to wean him off the car slowly so that he didn't feel like he does now. Obviously it's his decision but he's scared of taking a test and it would make him feel even worse if he failed (which he probably would because he doesn't function well when anxious).

Thanks for all the links. It's so nice that you took the trouble.

I'll see whether Mum thinks Dad may be willing to go to counselling. It's funny, I suffer from depression but I didn't think the approach would be the same when someone had dementia. Wrong again.:D
 

Sandy

Registered User
Mar 23, 2005
6,847
0
Hi chinwag,

As far as the CPN was concerned, she was assigned to monitor my MIL for the first four months after starting Aricept.

As my MIL is 84 and a bit frail, the consultant psychiatrist and CPN have tended to visit her at her care home. Once it was felt that she was doing well on the Aricept, her care was turned over to the local GP and the CPN visits stopped.

I know other people who are caring for spouses in their own homes and get a great deal of support from their CPN's. So it may depend on the level of support that is perceived.

To be honest I think it may be best if he calls it a day now that it's happened but we had planned to wean him off the car slowly so that he didn't feel like he does now. Obviously it's his decision but he's scared of taking a test and it would make him feel even worse if he failed (which he probably would because he doesn't function well when anxious).

I was hoping that you might say something like that :eek:. It may at some level help for him to feel that the license was taken away by a doctor's mistake with the forms, rather than any loss of ability on his part.

Have your parents contacted their local Alzheimer's Society? It could help both of them to meet other people who are travelling along similar paths:

http://www.alzheimers.org.uk/site/scripts/documents.php?categoryID=200121

Take care,
 

Recent Threads

Members online

Forum statistics

Threads
139,004
Messages
2,002,113
Members
90,775
Latest member
Jackiejan