A new study of Aricept type medications, cholinesterase inhibitors, has show it has a "modest impact" on the course of the disease. That's not much hope but more importantly it shows that other medications, anticholinergic medication, can interfere with the potential benefits and the Aricept can interfere with the effectiveness of these other medications. Anticholinergic medications include....Antihistamines, antidepressants, antipsychotics, antivertigo, cardiovascular medications, gastrointestinal medications, muscle relaxants, Parkinson medication, and medications for urinary incontinence. I will bet most of our loved ones are on at least one of these medications. So the Aricept type drugs are making them less effective and they are decreasing the "modest impact" of the Aricept type medication.
What stood out to me, relative to the recent question about Vascular Dementia and these types medication, is that it not only is less effective then it might be, it is also interfering with the effectiveness of the Cardiovascular medications they are on. hummmmm????
Hmmm... This is very complicated. I suppose the doctors have to really balance it out when it comes to what kind of med is necessary. Whatever helps is the key.
It is just like the drugs for women's bone density issue. Some drugs are dangerous and yet some are good for the bones. Some Estrogen pills are bad for cancer but are good for the bone (estrogen). It is indeed a hard choice. The worst thing is after some years, the drug fosamax was found to make the hip bone weaker! Now they have a shot (prolia) that is good for women and yet that could cause lots of bad side effects and I don't want to do that either. Too much vitamin Calcium is bad for the blood flow... Natural food is better.
We just have to be cautious and do what is good for ourselves at the time.
I found this news saying that antidementia drugs like aricepy delays nursing home admission:
October 11, 2011 — The use of antidementia drugs may give patients an extra year at home and delay admission to nursing homes, new research confirms.
The finding itself is not new, lead author Emad Salib, MD, honorary senior lecturer at Liverpool University, United Kingdom, and a consultant in old age psychiatry who is currently in private practice, told Medscape Medical News.
"This has been shown previously in the United States mainly, and perhaps in one study from Australia, but these studies were supported by drug companies. This British study is the first one which is not related to any drug company," Dr. Salib said.
The article appears in the October issue of The Psychiatrist.
Dr. Salib and coauthor Jessica Thompson, MD, from Peasley Cross Hospital, St. Helens, United Kingdom, compared 127 patients who were prescribed cholinesterase inhibitors in 2006 with 212 patients who were not to see whether they had been placed in care or had remained in their own home during a 4-year period.
All patients were seen at a clinic that provided psychiatric services for the elderly. Participants' mean age was 82 years; 219 (65%) were women, and 120 (35%) were men.
The most commonly prescribed cholinesterase inhibitor was donepezil, which was given to 74% of patients, followed by galantamine in 14%, and rivastigmine in 8%. Four percent of patients received memantine in combination with a cholinesterase inhibitor.
A diagnosis of probable Alzheimer's disease was made in 56% of the patients, 34% had a diagnosis of dementia possibly combined with Alzheimer's disease, and the remaining 10% had a diagnosis of Parkinson's disease-related dementia, Lewy body dementia, or other dementias.
In addition, patients who were not prescribed cholinesterase inhibitors had diagnoses that included senile dementia of Alzheimer's type, early-onset dementia, and dementia of combined etiology.
The mean survival from the time patients were first seen at the clinic was 33 months, and the mean survival time in a care home was 18 months.
The authors found that during the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those patients who took cholinesterase inhibitors compared with those who did not.
I find this study amazing since the majority of patients placed in a facility is not because of ADLs but because of behavioral issues. If they can not dress themselves or brush their teeth we can do that for them but if they fight with us, sundown, or have paranoid anxiety, that is why they are placed. Also these medication are more effective with early diagnosis. The problem is that most dementia patients are not diagnosed early in the disease. Much of the information I have read says there is only a 3 month lag between those with and without the medication. Just interesting with what is known
The previous study I talked about is something very new. They had no idea that these medications had such dramatic effects on other medications... and that was just one type of medication they investigated. You are right you have to balance the good with the side effects!