cessation of aricept

[zonk]

This is my first post for many months.
The nursing home doctor has stopped mum`s aricept medication as he believes that it can no longer help mum as it is only useful for early to moderate stages. I thought mum was maybe late -moderate but has obviously declined.
She is currently on anti - anxiety and anti psychotic drugs.
I am writing to ask for opinions as to whether I should investigate the possibilty of Exiba for Mum.


I want to do everything I can to help her quality of life (who doesnt?)
Maybe she would be less aware without the drug, and therefore less anxious.
One part of me feels that putting her on Exiba now will just be delaying the inevitable,and another part of me feels like I should try ANYTHING to slow the progression
But then I feel like "why would I want to prolong my mum`s hellish existance"
Now I am reallise this thinking is wrong as Exiba doesnt slow the progression, it just treats the symptoms
Now I am getting REALLY confused
I welcome your thoughts
Kind regards,
Jo

[angel_bear]

Hi Zonk good to hear from you.

Zonk I think your main aim here is to keep Mum happy and peaceful. She's going/gone through enough and doesn't need any more agitation and upsets in her limited time left on this planet.

The usual Antipsychotic medications we use at work for our agitated residents is Largactal (Chlorpromazine) which can actually cause further agitation in extended use, Tegretol (Carbamazepine) is preferred, unless there is an allergic reaction (potentially fatal) but is good in the short term, Litium (Lithium Carbonate) is also used and any side effects usually disappear when the dose is stablised but can cause tremors and oedema. Long term effects are Hair thinning, mild cognitive impairment (bit late for that). Seroquel (Quetiapine) is used in some AD cases, but can create High Blood pressure, altered liver function & glucose tolerance (not good for diabetics as you will get false readings) .. and it can zonk them out ('scuse the pun).

Anti-epileptic drugs such as Epilim (sodium Valproate) have seriously reduced agitation in my of my residents (and I mean seriously, this man has constant 24/7 panic attacks, up his epilim and he's so CALM! Not drugged up or anything horrible, just finally CALM!!)

Ebixa (also known as Memantine) is for Moderateto severe Alzheimers. It can cause fatigue, oedema, dizziness, headache, confusion, diarrhoea, vomiting, constipation (fixes the diarrhoea?) anorexia, nausea, agitation, insomnia, hallucinations, sleep disorders, delusions and anxety, coughing, bronchitis, urinary incontinence and UTI's (these are worst case scenarios may I add here) As long as she's not on any other antipsychotic, antiepileptic drugs, it should help her .. again, long term is not an option with any of these kinds of drugs.

There's another one called Exelon (Rivastigmine) but it's for mild to moderate. Ebixa is the only one for moderate to severe.

Then your looking at Antianxiety med's ... Diazepam (aka Valium), Ativan (Lorazepam) and Serepax (Oxazepam) are all short acting antianxiety med's (work quickly for bad episodes) usually making the patient drowsy and sleepy.

so now .. is that as clear as mud now??

Thought so.

Keep abreast of any medication changes, question your doctor, question any other medical personel .. and good for you for knowing what she's on/off and questioning it.

Keep up the good work.

Cheers

[zonk]

Thanks Sally
"Zonk I think your main aim here is to keep Mum happy and peaceful. She's going/gone through enough and doesn't need any more agitation and upsets in her limited time left on this planet."

Yes that is it exactly.

So she is on statins,paracetemol -sp, (nerve damage from shingles)Oxazepam (alepam) and a low dose of risperidone.

What do I do for her best welfare....explore the possibility of exiba?
to what evail?
would it enhance her life for several months or not?
given the possible side effects perhaps not
I just want to do the right thing for mum and in typing that I think I just realised what that is. No more hanging on.
(i decided a long time ago that there would be no peg feed...exiba may be the medical equivalent)
I find this to be more an emotional decision than anything else
the problem too, is that she is only 70
If my dad were alive i think he would try to prolong her life
but he is not, so I have to decide
But it doesnt really matter what I do, the end result is enevitable
I dont have to answer to anyone except myself.
I can let her go but I just want to maintain quality of life....exiba or not?

[kk857]

Hi,

My mom's on aricept and memantine. She's late-stage now. She's on no other meds. What we found was she is less agitated and easier to care for with the added memantine. Further, there's a new study underway in the USA to give a time-release of the aricept at an increased dosage with the memantine for late-stage patients. The meds tend to mask the decline for a longer period of time. My mom's decline is more like steps or stairs down than a constant slide. The key is to find the proper dosage, too little is ineffective and too much puts her to sleep. We haven't seen any downside to keeping her on the meds. I often find nursing home professionals eager to take patients off the meds other than psycho-active ones. Food for thought. I hope this info helps.