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Published on: January 16, 2012
by Dr. Kaycee Sink for Everyday Health:
Q: My sister informed me that my mom has been taken off of her Aricept medication because “she’s too far gone.” It’s my understanding that Aricept is the only medicine out there that is for all stages of the disease. Plus my mom isn’t in her final stage; she still functions physically, and she still has her memories of her childhood and other stuff. Are they wrong for taking her off her Aricept, and if so, what can I do to save my mom? (My sister has power of attorney for her.)
A: Donepezil (Aricept) is approved for all stages of Alzheimer’s disease (mild-severe). Memantine (Namenda) is approved for moderate to severe Alzheimer’s disease. The general recommendation of Alzheimer’s disease experts is that patients continue on a cholinesterase inhibitor indefinitely if they seemed to respond to it and are tolerating it. (Aricept is in this drug class; Namenda is not.) My personal practice is to continue the medications for as long as there is still some cognitive function to protect.
However, none of these drugs reverse the disease and are only modestly effective in slowing decline while a person is taking them. That is to say that none of the medicines we have will “save” her. In addition, not everyone responds to them. So, if your mother’s doctor felt that she was not benefiting from the Aricept – or that the side effects or costs outweighed any benefit – then it may have been reasonable to stop it.
I would talk to your sister about the reasons why the drug was stopped, and whether it was replaced with another medicine, like Namenda.
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