Q: My still independent mother is being treated with Aricept for early Alzheimer’s and Paxil for mild depression. I thought I heard somewhere that those two drugs shouldn’t be combined, but I forget why.

A: Good memory! OK, I am not a doctor, but I lecture all over the country with top dementia specialists who always say that Paxil is not the best choice to be used with Alzheimer's medication such as Aricept, Exelon, Razadyne or Namenda.

Don't worry, it isn't that the combination is dangerous for your mom. The reason is that in some people Paxil might have a side effect of mild short-term memory loss. Since the goal of the Alzheimer's medication is to slow down the progression of the dementia and short-term memory loss, it doesn't make sense to also take a medication that might be working against it.

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Since there are so many anti-depressants available, why gamble with one that might reduce the effectiveness of the dementia medication, even if ever so slightly. That little difference in her memory could mean the difference in your mom remaining independent longer and delaying full-time care.

The right combination of your mom's medications is so important, and hopefully your doctor will be appreciative to learn about this and wiling to try another anti-depressant. Be sure to also discuss the correct procedure for switching meds, as usually the Paxil dosage is gradually reduced, while at the same time the new medication is gradually tapered in.