What to expect from Aricept and what happens next?

[Jackcat]

Sorry for long post, got a few questions -

Mum's consultant told me today on phone that he is pretty sure she has Alzheimers, and he feels she should start Aricept asap. He has been very kind and gentle with her, as she has been in denial and very resistant to accepting she has problems from day one of seeing him. She refuses to co-operate with the memory tests (but was at 17 last time they managed to complete one with her.) She puts up a very good show in front of him, and I feel terrible about this but I had to speak to him separately behind her back about the reality of her life now, as we were getting so worried. I have been half expecting an AZ diagnosis myself for a while, as the anti-depressants they prescribed a few months back have helped her distress and anxiety levels to some extent, but her short-term memory is dreadful, as is her sense of time and place, and she still has many confusions and delusions. The plan is that me and my brother will tell her this weeknd, as we all think she'll take it better from us than him - she really hates the Dr, even tho' he's fantastic with her.

I am pretty sure she will co-perate with taking more tablets, she sort of enjoys the fact that we phone her every morning to remind her take her pills, but I'm wondering if maybe we shouldn't use the word Alzheimers with her, what do you think? As I have to tell her so many things repeatedly now, I'm worried about having to tell her about her AZ diagnosis over and over, seems so cruel - maybe it's kinder to tell a white lie of some sort? Got any ideas on how we can put it to her? She accepted the AD's on basis that they were replacing mood chemicals that her body wasn't producing properly - her gp's idea, which worked a treat.

I'm to scared to google Aricept, to many weirdo sites out there!

Would there be any harm caused by her taking Aricept if it turns out that it's not AZ she's got, but another sort of dementia, or just a really bad case of MCI? I'm conscious that it's been difficult for them to get to a firm diagnosis but don't want her taking medications un-ncessarily or that might make her ill in a different way......?

Also - can anyone can tell me what improvements Mum might get from taking Aricept? Also any side effects to watch out for?

TIA, and sorry again for such a long post, Jackcat x

 

[roseplum]

Aricept may not help every person who takes it. It wont cure, but MAY ease the symptoms, the person may find they remain at the same stage for a longer period of time, instead of progressing further. And thats about it reaaly, but like I said, it might not even make a difference.

Common side effects can be vomiting, diarrhoea, disturbed sleep, headaches to name a few, but again, not everyone will experience these.

I don't think (I'm not a doctor lol) it's a case of the Aricept doing any damage, or affecting your mum, it a case of will it make a difference to begin with.

Maybe it's worth a try, if that's what the doctor thinks.

Hopefully someone else with experience in this will come along and be of more help.

 

[jenniferpa]

A lot of people do just refer to "memory problems" when they are talking about dementia. Only you know how she will respond, but I see little point is emphasizing the diagnosis if you think it will distress her. If that makes you uncomfortable, because you are lying by omission, just think of it this way: even the doctor says he "thinks" it's alzheimer's and there is no way to be absolutely certain except by post mortem, so you aren't even really lying.

I was never given this opportunity with my mother (she had had strokes) but I would have had no hesitation in describing this as "a pill that might help your memory".

 

[sleepless]

Hello,
My husband was prescribed Aricept in 2003, and he remained very stable until this year, when things have begun to change gradually. He was prescribed it at a very early stage (not allowed now, due to NICE guidelines) and has had no side effects.
I hope your mum can reap the same benefits from Aricept that we have -- it isn't a cure, but it can stabilise symptoms for some time, so well worth a try.
best wishes,
sleepless.

 

[jenniferpa]

P.S. I would have tried mummy on Aricipt in a heartbeat: while not prescribed for people with only vascular dementia in the UK, it's used in other countries for people like that with some success. Other people have mentioned potential side-effects so you do have to be watching out.

 

[Nanak]

I was also worried about my Mum taking Aricept as I felt she was too far along the path of the disease before she was diagnosed. She has been taking it since January 2010 and frankly declined steadily since then.
But... and it is a big but.. we don't know how she would have been without it. .
I feel it is always worth a try at least if your Mum experiences side effects you can always take her off it but it is best to try it as early as possible.
Nanak
missing what has gone and scared of what is to come

 

[JackMac]

I think it is worth a try. My mum has been told she can't have it yet as she's in the early stages,despite evidence that it can help people in the early stages. I would love if she could try it.
what her doctor has told us about the drug is that it is like taking a headache pill. It just treats the symptoms, its not actually slowing down the disease or anything. So I think she would be okay to try it. But discuss your concerns with her doctor too.

I think improvements are seen fairly quickly if it works from what I have read. And I have also heard someone on here say that side effects normally clear up too.

 

[Nebiroth]

Aricept is only licensed for the treatment of Alzheimer's in the UK, therefore, it will not be prescribed unless there is a relatively firm diagnosis of that (keeping in mind that there is no definitive, physical diagnostic test so certainty is never possible).

It is not really possible to predict the effect of the drug will be - some people improve slightly, some people appear to get no benefit. It is difficult to tell whether someone is getting a benefit because that benefit may take the form of slowing down the decline - but people decline at different rates anyway; usually the only test applied is to see if people keep declining at the same rate they did before starting the drug, but that presupposes a lengthy period of test histories to use.

In any case, the drug does not treat the illness - only the symptoms. It works by increasing the level of neurotransmitters in the brain, which are involved in things like memory and espescially cognition. But lack lower levels of these chemicals is only one aspect of Alzheimers which is why the drug can only be expected at best to offer minor improvements. Moreover, the disease itself continues unchecked, and eventually you reach a point where you can't increase the drug dosage because it would reach toxic levels.

The best you can hope for is a temporary slight improvement (although of course to everyone, any improvement is massive).

The most common side-effects associated with these drugs (there are three, all work in the same way although chemically they are slightly different) are things like nausea, vomitting and diarrhea. Aricept is usually regarded as being the least likely to cause such effects. They are normally mild and subside after a while as the body builds a tolerance to the drug. It is normally given in a 5mg dose for the first four weeks, this may then be increased to 10mg; the low initial dose and slow increase (called titration) helps to minimise side-effects. If these occur at higher doses, this may be scaled back and tried again after a longer period on the low dose.

If side-effects are severe or persistent, it may be necessary to discontinue the treatment. At this point the alternative drugs (Reminyl and Exelon) may be tried. Although they are not usually the first choice as side-effects are more common with them, individual reactions mean that someone unable to take Aricept may be able to use Exelon with no problems.

Also, Exelon is available in a patch form. This is both easier to use for patients for whom tablets pose difficulties, also as it delivers a steady and continual low dose it avoids the "spikes" that tend to occur with swallowed tablets, and this may also help to prevent side-effects.

My father was on Aricept for several years and got some benefit from it. He was eventually switched to Exelon, because that drug is thought to be more beneficial for patients who exhibit behavioral problems such as agression, or have psychotic symptoms associated with the dementia (such as paranoid delusions).

There have been case studies of Aricept being given to healthy persons to see if it improves thought processes generally and also trials of it for people with mild cognitive impairment. Whilst improvements occurred, these tended to vary from person to person and were not sufficient o warrant the drug being used more widely, or as a preventative for people thought more likely to develop dementia. However, it does indicate that it is safe to use even for people who don;t have dementia.

Many countries use the drug more widely than the UK - it is often prescribed for dementias other thanAlzheimer's.

 

[Canadian Joanne]

My mother used Aricept for several years and we found it beneficial. I don't recall that she had many side effects either.

However, we never told my mother she had Alzheimer's as every time we tried, she started getting very agitated and aggressive. She was quite willing to accept that her memory wasn't what it used to be and had no problem when we referred to her having memory problems. So that's what we did, to keep her as settled as possible.

 

[PollyP.]

My Mum (age 94) has been on aricept since Nov 09. The difference in her is amazing. Years ago she was very good at crosswords and reading, but in the early stages (prob a few years ago) she lost all interest in doing crosswords or reading library books, but now she is great at both.

I refer to Aricept as her "Crossword" pill and have explained that it helps with the chemicals in her brain. I did once try to explain that she had been diagnosed with Alzheimer's but I think she didn't want to hear it and dismissed it from her memory? I never mention Alzheimer's to her now. There doesn't seem to be any point as she accepts her memory loss as part of old age.

I hope that your Mum finds the same benefit with the medication.

Pauline

 

[HomeAlone]

my mum had visual nightmare distubances, with aricept...but that was sorted ok, by taking the aricept in the morning , i believe nausea in the early days is a symptom, but the benefits are good (or were for her )

 

[Jane3006]

We had to take mum off Aricept, but if the same position arose with say my husbands mum I would still say try it and see. I agree with everything that has been said on here and really there is only one way of finding out if it can help. I believe strongly that some people get a really positive affect (remembering its not a cure). As for my mum, it made her very aggressive and did not slow down the Alzheimers, but still we dont regret trying because she may of been one of the lucky ones. I wish you loads of luck and really hope it will help.

 

[graybags]

All I can say is that in my father's case we have not noticed any side effects and we have not noticed any detereoration in his general condition. As others say this could just be how things would have evolved anyway but I certainly wouldn't want to have the Aricept withdrawn.