You hear about Aricept alot, but does anyone have a loved one on Galantamine? That is what the VA has my husband on. It has been about 6 weeks since he went on it and I see no change. He is also on Prozac.
We are waiting to get into the neurologist here in Portland for the second opinion. His first appointment at the dementia clinic is the 5th.
I do know that Galantamine is the generic name for Razadyne, Razadyne ER, Reminyl and is used for mild to moderate ALZ and Vascular Dementia. It was originally derived from Eastern Europe which using the bulbs and flowers to relieve symptoms of Polio. It was later developed for use in dementia. Neither of my parents have been on this med. They are both on Namenda and Aricept.
You will not see an improvement on any of these meds. They do not claim to make the dementia better or to cure it. They only claim to slow down the progress of the disease and that is hard to see.
Welcome to the board. Be sure to ask the doctor's that you see about this medication and the possible side effects and what you should expect. I do hope both of your appointments go well and you get the answers you need.
May I ask why he is on Prozac? That is a difficult drug to wean off of. My father had vascular dementia also. My Mom had AZ. I lost both of them a year ago-5 weeks apart. Does your hubby have Alzheimers?
Deb is correct. YOu won't see any improvement with those drugs. They only stop the rapid progression of the disease. They only claim to help slow down the downhill slide. And how rapidly that happens is a crap shoot at best. The two most popular drugs, Aricept and Namenda, are only good in the early stages as it is.
Welcome to the group. Has your hubby been checked over by a good gerintologist? Are you working with him at home? Are you looking into AL for him? Keep us posted as to the results that you get from the doctors appointments.
He is on Prozac for depression. When he had the nuero-psych workup the doctor recommended the dementia clinic and anti-depressant. I was so praying the short term memory was due to depression - not Alzheimer. Things have happened in the last 4 years that would cause depression in anyone - especially someone who does not talk about his feelings.
After his MRI results came back - that prayer went the wayside. But I still believe depression is part of it. The neurologist (I had to pull it out of him) that he has front lobe shrinkage - but with no previous MRI it could always have been that way - and dementia. Due to family history of EOAD (he is 61), he said it is probably Alzheimer. We have an appointment next week with another neurologist for a second opinion and hopefully more details as to what to expect in the future. And then we find out what the dementia clinic is all about.
I realize Galantamine or any of the drugs currently used only slow it down and are only good for about 18 months. He can still do things like right now he is fixing a plumbing problem in my sister's house, but his short term memory is what exhaust me.
I can look back and see where there were signs as long as 4 years ago. A year ago is when I really noticed it happening often and pushed him to see the doctor. They did the neuro-psych workup and CT scan and was told all was fine. It wasn't until this summer, while in NV that he got a copy of the psych workup which recommended the anti-depressant and dementia clinic. I was really upset with the VA for not getting that to us earlier, but then they could have. Could be he was wrong in what the doctor said. Could be he wanted to travel so bad he was in denial. (we are full-time RVers/Workampers). He still drives fine, so once we get his treatment and prognosis more defined, we will travel again. i will just be the one working with maybe him doing less stressful jobs that have routine.
I do understand the depression/dementia delima. Mom was diagnosed with depression for more than three years because she went to the Memory Assessment Research Service and came home with a diagnosis of Moderate to sever dementia consistent with ALZ. Evidently the "depression" she suffered was truly ALZ and her reactions to the disease and the chaos it created in her world. Yes, we did notice small things over those years but they were always explained away using the depression diagnosis, the fact that she was Dad's full time caregiver, and most often "Dad did it". We had all known for years that Dad had dementia so it was easy to blame any bizzare occurance on him. Besides, if she didn't remember doing it then he must have done it and of course he wouldn't remember because he has vascular dementia and NO current memory.
The frontal lobe shrinkage is a telltale sign of dementia. It is hard to be definitive without a previous MRI to compare but it is not to be overlooked as normal.
We took Mom to a Memory Assessment Research Service that specializes in early detection of dementia and it's treatment. I am not sure what test your clinic will entail but Mom had an all day series of cognitive test. They were able to tell us which cognitive functions were impaired at what level. We know her auditory processing is the worst. What she hears doesn't process in her brain. Her visual processing is better so we tend to show her rather than tell her and that definitely helps. Hopefully you will get information as to how to best help him as well as details about his specific deficiencies.
As for driving, you do need to be very careful and get the clinic's recommendation on his ability to drive. They absolutely remember how to drive. They have been doing that function most of their life and it is inbedded in their long term memory. The problem is that they are not able to process current situations in a safe way. Their ability to react is limited. Something or somebody is in the road and it will take him too long to process and adjust to the situation. Then there are the current memory problems. They don't remember what they just did or why they are where they are. These and more are the problem with driving. It's not the actually driving but what to do if something happens outside of the normal riding down the street. Mom ran over a yard statue, crushed it flat, and had no idea she had done it. She would back out into the road without looking for oncoming traffic. Yet she could drive fine. We found this the most difficult issue to deal with and for her to deal with. I mentioned this so you would be prepared since you are both avid RVers....
If you have not done it already, you need to get a durable POA from him, Medical POA or medical directive, be sure you are on his HIPPA form at all doctors, and be sure your name is on all accounts. This will be imperative when you need to act for him as his disease progresses.
Again.... welcome to the board. I do hate that you need to be here but glad you found us. Let us know what you find out in the upcoming appointments and know I will keep you both in my thoughts and prayers.
Prozac is a hard med to deal with. There are other meds that they could try for depression that would be easier for you in the long run to wean your hubby off of than Prozac. Just an opinion. With dementia you will be having enough other issues that having a drug dependancy isn't something that I would want to deal with also.
Deb is making a great point about your hubby's driving. My father had vascular dementia and we had to take away his car. Daddy had never had an accident until he was 86 or a ticket! But they lose their ability to react quickly and they cannot respond to new and unusual situations with the same response time that they had. It may be wise for you to assume the driving in the very near future....or you may need to start looking for a long term spot that will be home if you don't have one already.... But driving should be something that you bring up with the doctors right away-not only for your own safety and your hubby's. But the safetly of the others that are on the road with you.
I hope you get the answers that you need from this next go at the doctors. Welcome to our gang and keep us posted....
It's not that hard to come off Prozac. I was on it for a few years and came off it with no problems. You just have to do it slowly.
His driving is fine for now. We were out driving in traffic and did fine. We were in an area where we use to live and had no problems remembering his way on the back roads. That was a nice change.
I do realize there will be a time he won't be able to drive and as we find out more, we will cover the things we need to. Right now I am focused on finding out what the doctor says and the will. Everything we have is joint with right of survivor ship He already signed a medical directive on file with the VA.
My husband had his appointment with the geriatric neurologist. After lengthy testing by the geriatric resident, then conferring with the neurologist, she gave the diagnosis of MCI. Right now they can't say Alzheimer because only a small percentage develop into Alzheimer. With a family history like he has, 12-16% will develop in AD. He goes back in 6 months.
It was good that he tested better this time than last February. Whether that is because he was more relaxed, the anti-depressant (i felt his short term memory loss was due to depression) or the galantamine - we don't know. He will stay on both.
The doctor was very open to the supplements he is taking: fish oil. CoQ10, Acetyl L-Carnitine, Vit E, C, B-12, Red Yeast Rice, and Cinnamon. He does word searches all the time, which is good. Was told to keep doing activities to create new brain cells.
It is a relief for now as he can continue to do most everything except maybe work. If he had been working then it would probably not be as much problem. But, we had just left a seasonal job so were in between workamper jobs.
I am glad the test turned out as well as they did all. The reason is not important. Keep doing what you are doing, return for follow ups, and hope for the best. I am sure it was a great relief and I do hope he stabalizes. It is nice to hear a good diagnosis for once
MCI is mild cognitive impairment.... It's somewhere between normal aging and true dementia. It can be caused by anything from medication to medical conditions to brain disfunction. It is not necessarily a precursor to dementia. Basically it's that fuzzy gray area between normal and something definitive wrong. This is the area that the Memory Assessment Research Service Mom went to is trying to investigate. They want to find a way to determine when MCI will develop into true dementia and then they can treat it at that time with known or new medications and dramatically slow the onset of dementia. Right now there is not much known related to which MCI patients will develop true dementia....