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At what point is Donepezil stopped

Discussion in 'I care for a person with dementia' started by Linbrusco, Mar 30, 2015.

  1. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,539
    Female
    Auckland...... New Zealand
    Mum with moderate AD diagnsoed June 13, has been on 5mg Donepezil for now over a year. 10mg didn't agree with her tummy.
    Since Christmas her short term memory and cognitive function has declined further.

    Mum has known my husband for 28 yrs. Mum & Dad live in their own house at the back of our property and have done for 8 yrs.
    Yesterday, although my husband did have his back to Mum while we were outside in the garden talking, she did not recognise him.
    There is no mistaking my husband, as he has very short hair with a scar from head surgery or his voice :) but yet Mum still didn't know who I was talking to until he turned around.

    On Sunday morning Mum woke, insisting it was Monday and she had to get ready for her group. Dad told her it was Sunday , but she would not beleive him, despite all our cars in our driveway, she thought we were at work and the kids were at school.
    She insisted Dad was trying to make her late, and Dad said she was getting quite stroppy.
    Once she saw me come out my house and looked at her calendar she accepted the fact it was Sunday.
    She can now repeat the same sentence 3 or 4 times in the space of 5 minutes.

    Mum has just had blood tests and urine tests done end of last week, which were all clear.
    Funnily enough when she saw her GP, she was virtually right as rain :rolleyes:
    She has an appt in May to see the geriatrician.
     
  2. Izzy

    Izzy Volunteer Moderator

    Aug 31, 2003
    58,718
    Female
    Dundee
    My husband's drugs for Alzheimer's were stopped when he reached a specific score on the MMSE test. I have a feeling that the score was around 10 when they were stopped. He was on Donepezil for a good number of years then changed to Rivastigmine. Eventually this was stopped as it was felt it was making no difference. It might be a possibility that your mum could be changed to Rivastigmine if the memory clinic doctor thinks that this might be helpful.
     
  3. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    I was also told the cut off point is 10/30 on the MMSE test (NICE guidelines apparently)

    Linbrusco, perhaps you could try to get the appointment bought forwards?

    Take care

    Lyn T
     
  4. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,539
    Female
    Auckland...... New Zealand
    Mums MMSE score June 13 was 19/30. Not sure if it would be as low as 10, but definitely several points lower.
    I am trying to see if Mum can see an alternative geritrician.
    No offense to anyone that doesn't speak English as their first language but Mum cannot understand the one that she has. She just laughs along with him and nods her head, and we relay when she doesn't quite understand a question.
    Mum is from Scotland :)
     
  5. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,839
    Suffolk
    How do they know the score? OH hasn't been tested for years!
     
  6. Beate

    Beate Registered User

    May 21, 2014
    11,490
    Female
    London
    Really? We get tested every 6 months or so, though last time the test wasn't completed as OH was struggling with it. We are going to the Memory Clinic again today and I am scared they will stop his meds as there is no way he will score over 10/30 now.
     
  7. Izzy

    Izzy Volunteer Moderator

    Aug 31, 2003
    58,718
    Female
    Dundee
    Bill was tested every 6 months until he came off the medication. We no longer go to the memory clinic.
     
  8. Sammyjo1

    Sammyjo1 Registered User

    Jul 8, 2014
    194
    We're very lucky because OH is doing well on donepezil. He scored 27/30 when he went to the clinic last week and I thought they would send him away but they are now seeing everyone every 6 months because they feel the GPs are not spending enough time with dementia patients. So we will go again in 6 months
     
  9. nitram

    nitram Registered User

    Apr 6, 2011
    18,303
    Male
    North Manchester
    "I am scared they will stop his meds as there is no way he will score over 10/30 now."

    If he is on a cholinesterase inhibitor, e.g. Donepezil, they may change to Memantine.
     
  10. little shettie

    little shettie Registered User

    Nov 10, 2009
    218
    Sorry to jump in on your post, but my mum is not seen on a regular basis. Whats this score everyone's talking about? She was seen before Christmas only because we moved and had new GP and they referred her to a local mental health team psychiatrist but before then, nothing regular and nothing since the last one. Mums been on Aricept since her diagnosis 5 years ago. Not sure if it now works but last time she was seen was told just to keep her on it as no side effects were evident. Mums also on citalopram anti depressants, since we lost my dad two years ago and was recently put on a higher dose as she became very depressed again. The MH psychiatrist told me off and said people over 65 should not be on high dose anti depressants! Well the Gp prescribed them!! Oh well he said, GP's are not really up to date with all this!!! Flabbergasted! But needless to say the higher dose made a huge difference to mum so I've kept her on them as there are no obvious side effects.
     
  11. Beate

    Beate Registered User

    May 21, 2014
    11,490
    Female
    London
    Good news - he couldn't complete the test but it was pretty clear he was all out at sea with even the simplest question. But they will not stop the Donepezil, and they don't routinely switch people over to Memantine so it looks like it will be Donepezil for a while longer!
     
  12. Taximan

    Taximan Registered User

    Mar 31, 2015
    13
    How do you tell if medication works

    My wife was finally diagnosed with Alzheimers just over a month ago,even though I took her to the gp almost twenty months ago.She has been given Donezepil 5mg,she hasn't had any side effects,but what exactly can I expect this medication to do?.In just under two weeks she has a prescription for the 10mg dose,that prescription is for three months,what shoul I expect then.I've noticed that some people are talking about tests,are they saying if your test scores get worse that the medication is stopped,and what are these other medications that are mentioned,I've never heard of them.:confused:
     
  13. Sammyjo1

    Sammyjo1 Registered User

    Jul 8, 2014
    194
    The scores we are talking about are the standard memory test scores. The way it worked in our case was as follows:

    The GP we saw gave OH the test (questions like what is the date, asking them to copy a diagram, asking them to remember some words) and then the score is used to indicate whether there are memory problems. As OH scored 24 out of a possible 30, the GP sent him to the memory clinic where he had a CT scan which confirmed the AlZ diagnosis.

    The memory clinic were then responsible for prescribing donepezil (which is also known as Aricept), monitoring his response to 5 mg in the first place, and then to 10 mg. After that the memory clinic referred him back to the GP for prescribing the drug. The memory clinic now sees OH every 6 months and does the memory test each time to monitor how he is doing.

    Donepezil doesn't work with everyone but it has radically improved my OH's awareness and general well-being. I think the other drugs would only be suggested if donepezil wasn't proving effective.

    I hope this helps - please do ask if you've got any more questions because this whole thing is a minefield!
     

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