89-year-old woman living independently with 2 hrs of agency help and family intervention. Doctor wants her to try Namenda.

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She had bad side effects from Aricept &she is a very anxious woman by nature. I objected stating that the twice a day dosing would be difficult we set up her am meds & call her every day & that works) & then he started trying to get me to buy some fancy automatic pill dispenser. I wonder if it isn't broke & the Namenda won't improve anything is it worth changing her routine? Also, the SE of agitation, depression & anxiety concern me. I don't like to go against a Dr's recommendations but was not impressed with his presentation or his lack of good answers to my questions (he's a Neurologist not her primary MD).

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I just looked up the name Namenda. I didn't look around completely but the drug's own website says it is more effective if used in combination with aricept, another alzheimer's medication. You have to remember that it won't reverse decline it will only slow it. At least with Aricept you wouldn't know if it was helping the decline because you don't know how fast it would have progressed without it. I was told by a psych md once that he didn't consider aricept to have any help. My mom was on it until about 2 months ago and I don't notice any difference in the rate of decline but my mom has late stage, non Alzheimer's, dementia.
If her neurologist thinks that Namenda may be helpful, I'd bend over backward to try it out. And the only way you can know whether it is suitable for your loved one is for her to take it under careful observation. Side effects are always possible, which is why these kinds of drugs are generally started at a low dose.

Could you set up this second dose in a different colored pills box, and call to remind her about that each day? Could the agency help see about this dose? Would insurance cover that expensive pill dispenser? (My mother just had one set up for her. So far so good.)

Dementia is such a tragic and heartbreaking disease I really hate to see something that MIGHT help not being tried because it is inconvenient. As you saw with Aricept, there are no guarantees. A drug that works well for countless people can be ineffective or have harsh side effects for others.

I'd follow the doctor's orders.
Nemenda has a much lower side effect profile than Aricept. Neurologists aren't best known for bedside manner, but are known for being really smart. Give it a try and see if your mom has the side effects you are worried about, or if it is helpful. Give it a few weeks and see what you think. If something major comes up, call Neuro's nurse, for input from the Neurologist. My mom was on Nemenda for many years and combo therapy for five or six years. Didn't do well on Aricept, Fine on Nemenda and best on Exelon Patch w/ Nemenda and Lovaza (RX omega #3). We are all a little different. Most med's. require some trial and error to get optimal target symptom control. However, here the real goal is slowing progression of a very debilitating illness--not significant improvement like an aspirin for a headache. I agree with Jeanne--try anything that might help. If a med change can't be managed in IL, maybe she needs more help? Left untreated or undertreated, you will spend lots more than cost of automated pill box, regardless of what ins does or doesn't pay. Different color boxes might be adequate if you really can't obtain the automated dispenser. I hope you consider trying the Nemenda. Maybe that doc isn't the one you'll want to stay with. As things move along, you'll need to be able to have good communication with mom's doc. Maybe if you try his advice, he'd be easier to work with as you develop rapport? Good luck.
Thank you for the input & I probably will try the medicine but I was very put off when the neurologist was so blase' about the really practical solutions for taking care of someone who gets upset & anxious about ANY deviation in her activities. It wasn't the expense of the automated pill dispenser but how complicated it looked -- my mother hasn't been able to answer the intercom in her apartment for the 11 years she's been there because she thought it was too complicated & that was BEFORE any signs of dementia! When he mentioned that the worst side effect of Nemenda was severe agitation I nearly fell off my chair. Why would I want to put my mother through that when there doesn't seem to be any measurable way to tell if it is or isn't doing what it supposed to do (which sounded like "nothing"). I don't want to be small minded but I work in the health care field I know Dr's who far too often just want to throw another pill at you. It does sound as if at least one person here felt it was helpful so I'll try it and hope for the best.

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