How do doctor's choose which Alzheimer's medication to give?

To marymember. There is absolutely no proof or link that cell towers or cell phones cause memory loss or cancer. This hype was started by some nutcase looking for fame years ago. I've worked for communication providers many years and also in air traffic control. It's the same blah by naysayers. Put something out for the news media to grasp and they will run with anything that provides a story..whether true or not. It makes me so upset. If cell phones or towers caused cancer then so would ALL phones, ALL computers, ALL fax machines, ALL radios, ALL DVD players, ALL ipods, ALL ipads, ALL headsets, ALL digital washer, dryers, microwaves---anything that has a diode, magnetic chip or electrical current. My goodness, we would all be dead!

Given that AZ pre-dates telephones I think we can decide that cell towers are certainly not the ONLY cause of dementia. If cell towers, why not the wiring in your walls (only around since the '20s)?

This spring I attended a full-day conference for family and professional caregivers of persons with dementia, called Meeting of the Minds. Speakers were typically researchers or clinicians well regarded in their fields. Some of the things I heard (from more than one speaker):

1) There are only 5 drugs developed and approved for treating dementia. None of them are very effective. (Some individuals may benefit, but the overall profile is dismal.)
2) No drug developed so far can alter the course of the disease. They don't "slow down" the progression. If they are effective for an individual that means they relieve some of the symptoms. The disease will still progress.
3) The next round of research is focusing more on learning about the disease, so drug manufacturers have a better target.

Note that there are other drugs, not developed specifically for dementia, that are often used to address symptoms. Those, of course, do not slow the disease either, but if they help manage symptoms they may be very worthwhile.

My husband was very adamant about not prolonging his life. In fact, he had his defibrillator removed. But we tried every drug his neurologist suggested, and continued with the ones that seemed to help. Some were almost miraculous! Our goal was always to make the time he had left as meaningful and comfortable as possible. He lived with Lewy Body Dementia for ten years. I can't imagine how much worse those years would have been without the drugs.

I hope the next generation of drugs will be much, much more effective. But we are stuck in the pioneer phase of research. I say, try what is available and if your loved one is one of lucky ones it works for, continue with it. No results or bad side effects? Discuss with the doctor the safe way to discontinue.

My thoughts about cell towers contributing to Alzheimers are that the more basic research that is done and the closer we get to a full understanding of how the brain works and what goes wrong when it doesn't work the more we'll be able to identify (and hopefully change) any environmental factors that contribute to dementia. We just don't know enough yet.

Support basic research!

What are your thoughts about cell towers contributing to Alzheimers?

I don't guess I ever thought of the meds (Exelon patch and Namenda XR) extending Mom's life.....and suffering.....but I've seen the frustration on her face and the panic in her eyes when she is trying to express herself and the right words will just not come. I'm just hoping the meds make her life more liveable while she is here on this earth.

Nojoy I love your answer. It is so true...Why do we want to slow the Progression... I am sure they would want IT OVER WITH. Its those left behind that want these drugs. Dragging out a disease that is so awful. My partner has Parkinson and obviously something more severe as he is terminal at this moment and it is hard to believe how fast this progressed. Today, the nurse turned up his oxygen. I said oh Good...But as soon as I said it, I realized that I was again prolonging his suffering. He is on Hospice and they are very good about making sure the patient is comfortable. But, the reason we choose Hospice is to avoid the tubes and interventions that the hospitals use and are probably not really sure it will work or not. And for who are they prolonging the life? The older I get the more I realize that our modern society is so strung out on provisions to prolong a persons life when they are suffering. Obviously, we want to die in GOD'S TIMING. But, these drugs only put off what will happen eventually when it comes to Alzheimers, and Parkinson there is NO CURE. Someday they will find out why it happens. And, everyone will say WOW But in the meantime do these drugs really work? And if they do how much of a percentage are they working and how much more life will we get out of using the drugs? Will I be in a Memory Care unit if so, why did you give me these drugs. Why did you not just let me go. As for the pain,,,,YES, use drugs and freely to avoid any pain they are suffering. I am all for that. Pray about your decision and then talk to your doctor and get the questions answered,,,,It is a HORRIBLE DISEASE.

My question is this: We know that none of the medications currently available will cure Alzheimer's Disease. We know that the current meds available reportedly only "slow the progression of the disease". We know that this is a terminal illness and that our loved one will die of this disease. Why do we want to slow the progression of this terminal disease? Why do we want to give these meds that only "slow the progression" of this horrible disease?
Please don't think I'm hard. Both my folks have suffered this disease. Both have taken the meds. These are questions I've asked myself many times. Was it really of value to either Mom or Dad to give them a medicine that only delayed their demise or would it have been better to just have let the disease run it's course rather than dragging out their suffering. I have no answer.

My husband had the same problem, loss of weight and vomiting, could not hold down his food. The doctor took him off it. he never had a problem with the Namenda. He is now on Namenda XR He now eats everything on his plate and is gaining his weight back, I was told everyone has a different tolerance for the Aricept. Both meds slow the progression of this sad disease, where we have to watch our loved one changing before our eyes. Good luck to you and take care of yourself!!!

What exactly is Cerefolin NAC? marymember

My husband takes both. I just don't know if they do or don't help. Maybe taking them in the evening is best rather than earlier. I would like an opinion.
He forgets what happened today. He can't explain his thoughts. But when we are in the car and I am driving, he can tell me exactly when to stop, when to turn, how to back out, etc. His driving skills are there...marymember

My mom had nausea so bad with Aricept that she could hardly move her head for fear of throwing up. She lost about 20lbs. on the med. Has had no problem with NamendaXR.

Does Aricept help with mobility I was told I should have kept my husband on this medication, but when taking it he was not eating good and when he did he would vomit, so now he is on Namenda XR and he seems to be fine. Has anyone else had this with their loved ones..

Some of these medications are very expensive, (Namenda XR for example.) Often the same medication or an equivalent generic can be obtained from Canada for significant savings. Do an internet search for "Canada prescription drugs" for price comparisons.

Doctors often choose the medication he/she thinks will best manage the manifestations of the illness since different people having Alzheimer's behave in different ways.

I appreciate your very thoughtful answer, Grammy M. I think of my caregiving as a creative challenge and I try to do the best I can to make my husband's days pleasant, which, in turn, makes my days pleasant. My husband was put on Namenda XR by his neurologist about 5 months ago. It's hard for me to know if it is helping because the progression of his dementia has been so slow. He doesn't have any noticeable side effects from the drug so I'm torn about whether or not to have him continue with it. The neurologist claims that the benefits may not be evident now but 10 years out he will be significantly better off if he continues on the drug because the rate of decline will have been slowed. For now I will keep him on Namenda but I question whether it's really slowing the progression of his disease. The drug companies can make claims that their drugs make a difference but how do they measure the effectiveness?

Make sure they don't prescribe Risperidone, the side effects are terrible, and it shouldn't be given to the elderly, but is because of the kick backs from the drug companies.

Here are my thoughts on the medications. We all know there is no cure, no magic pill to restore what has been lost mentally or physically. We give our loved ones the prescribed medicine in hopes that it will slow the progression of its hoŕible disease take them away from us. Does it work or help....there is no way of knowing if they are better off taking it or they would be worse if they didnt.. my dad has been taking both aricept and namenda for almost 4 years with no side effects that I can see. I don't know if it's helping but I don't think it hurting.

The doctors don't know squat about Alzheimer's although they pretend they do. I arbitrarily took my husband off Namenda because it was confusing him. He has done better without it. No doctor can tell me what is best for my husband because he/she doesn't live with him day in and day out. Also, I highly recommend y'all read the book, "The Myth of Alzheimer's" written by a neurologist. It is an eye opener. There will never be a cure for Alzheimer's. In the old days, it was called "hardening of the arteries." It just is, that's all, and it will continue to be. Read the book.

from Luanne30 my husband has fought the demons of depression for many years and has been on medication continually since 1980. He has been able to live a successful ad fulfilling life in business and as a wonderful father, grandfather, and now great grandfather- also husband. The dementia has been creeping in for about five years - not noticeable as such, in the beginning. When he started noticing his failing memory and inability to complete sentences etc, he was very worried about alzheimers. His psychiatrist and our family doctor assured his that he did not have alzheimers but was just aging. Finally we had a brain scan done which proved just that - an aging brain - no symptoms of alz. or strokes etc. Both doctors said that there was no medication proven to help the situation. The last three years have been steadily downhill - slow but sure. He is often confused - no longer able to drive - sometimes can't get dressed alone - and doesn't seem too interested in any "senior" activities. Often tired - sleeps a lot while watching movies, and doesn't concentrate on reading-which he used to love. He loves having family around - but also withdraws from lots of activity. Like Granny said, it is losing someone a little bit each day. So we try to make the moments "happy" and upbeat as much as possible. He still loves to watch the great grandchildren play hockey and baseball etc. We haven't tried any of the meds mentioned. It is sometimes an event just to sort out the pills he does need. And after we finish sorting them out, he rechecks them and sometimes puts them back so we start over again. with a smile (:

My mother was recently put on Namenda XR. It has calmed her down tremendously. Now she is almost 'too calrm', but we'll gladly take that rather than the panic/crying episodes she was having.

Grammy, thank you for sharing not only your experience but your very personal emotions of your caregiving journey. You have a well balanced concept of that unfortunate journey.

You may have to adjust them a bit. Its a little trial and error. My mom started on Aricept and it helped so we increased it and she had a lot of trouble sleeping and became violent. We reduced the Aricept back down and added Namenda. After a while we upped the Namenda and the Aricept and she accepted that well. Of course not getting any better but I feel like it definitely slowed down the progression. Doctor said there are really only two basic groups of Alzhiemers medications. Namenda is in one group and Aricept is part of another group so you may have to just try one combination for a while and if there are side effects, try switching to another brand.

My partner is on Ropinerole 0.5 mg 2 in the morning 2 at night. But, he also has antidepressant meds as well as diazapam, and pain med (tramadol) and Gabapentin for nerve pain. His pain is overwhelming at times and tramadol is very mild. They are afraid to try a stronger pain med due to his rash that pops up now and then. So, no distruption in the pills he does get.

Sometimes I think the drug chosen has the most benefit to most, or is based on the kickback from the pharmaceutical company. No drug will help stop dementia, and giving them opens the patient to some side effects which are mostly unpleasant.

I agree with Matt383 answer. We all know Alzheimer's cannot be cured; that drugs administered are given with the hope of slowing the process down. Depending on the doctor, some more aggressive than others, will prescribe medications to see if there are any noticeable results with their Alzheimer's patients. Saying that, at the last check-up with my husband's PCP, and after 9 years of being on Aricept and other meds, the doctor looked at me and said, "the pharmaceutical companies are getting wealthier by the minute with these drugs. In all my years as a doctor, I have not seen one ounce of good taking these medications for Alzheimer's have done for my patients. Therefore, to save you money, I recommend your husband no longer take any of these drugs. See if you notice any difference..." So, following the doctor's advice, I did just that. Took him off meds and watched him closely. Nothing changed mentally. If anything, once he was off the meds, his walking and stability improved. I've talked to many caregivers who have cared, or are still caring for a loved one. Those who have lost a spouse after years of devoted care and thousands of dollars poorer mentioned that giving hope is nice---sometimes that is all we have, but drugs did not help their loved ones. It was like dangling a wishbone in front of them every day hoping with all hope that would be the day improvement would begin. It never did. I honestly do not believe there is a right or wrong answer to your question. Perhaps your mother's doctor is reaching out hoping a prescribed drug will help your mom. I have replaced Aricept and Namenda with grace, understanding and love. I look into desperate, pleading eyes every day and gently hold a hand, go for short walks, look at flowers, birds and an occasional airplane overhead. I seldom understand what my husband mumbles, but I always respond. I tell him how nice he looks, he's walking better today, did he brush his teeth and comb his hair? The response is always the same..."why yes, I did." I smile because I know it makes him feel better to respond positively, but also know without my help, he cannot do those simple tasks. And then while watching him nap, I look at him and I start to cry. A confused, empty world filled with love...a world that only a caregiver truly understands. Please keep in touch and let the viewers of this wonderful website know if any meds help your mom. I will be praying for her.

Cerefolin NAC is pretty much a vitamin supplement thought to help with brain health. That seemed better for a few months for FIL but then not so much. Then the doc gave him Aricept, same thing, brightened him up for a few months, doubled the dose, a few months more then not so much. Currently taking that with another med, a bit better for a while, then double the dose ....and the story goes. Apparently these meds really just help with symptoms for a while, none of them cure the disease and it looks like they just are temporary stops in the downward spiral. BTW if you are buying the Cerefolin from a drug store it is half the price if you buy it direct from the company, they still require a script but will ship direct to you. Our insurance would not cover it since it was considered a food supplement. Good luck!

In our case I think the doctor gives mom the meds that have worked with his mother, who alz is farther advanced. We usually compare moms on our visits. Aricept made mom very nauseated and we had to stop it. She tolerates Namenda XR and I do think it has slowed down her decline. He added Excelon patch several months ago but I don't think that's helped. She slowly goes down each day. Just little ways, like telling me to answer my shoe when the phone rang but it has been slow so she is with me for awhile longer than she would be otherwise.

I would be interested to hear any success stories regarding any of the drugs used to treat als/dementia. My Dads doc says none are effective. I doubt I could get dad to take any but who knows. Is any of this stuff worthwhile? Btw, Dad is 85 with major short term memory loss.

I wouldn't worry. Those drugs only help about 10% of the people that take them.
I took my mom off those things after advice from a doctor. She was actually better off the meds and saved a ton of money.There are several side effects from those drugs.
See if they help and if not, stop taking them. I am sure your doctor is trying what he seems to have the best success rate with which is not much I am sure.

Any help would be appreciated.