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My mother has moderate dementia at age 88. Her doctor suggested Aricept first. I looked into the mechanism of action of the drug and, realizing it increases availability of acetylcholine in the brain, began giving my mother a choline supplement, which made and continues to make a positive difference. Upon reporting this to the doctor, the doctor was skeptical that the choline made any difference, although during that appointment my mother was considerably more coherent and focused than she had been a few weeks prior. We began with the Aricept, which resulted in two days of vomiting. I took her off of it, and she recovered rapidly. Now they (the Dr. and Neurologist) want to try Namenda. My gut/intuition tells me no (as it did for the Aricept). As I am researching, it seems the majority of posts report marginal or negative effects. Any comments/experiences? Thank you.

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It's a tough decision. This is what I considered.

My LO has VD, and later thought by her psychiatrist to have Mixed with AD, so, at that point, we were offered medication, however, she was so advanced at that point, it was thought that it would only have impact on mood. At this time, she was on medication that really helped her anxiety and depression and it wasn't needed. I did research it and was never really convinced that the medication was that helpful. My LO has delicate bowels, that were currently fine, so, I declined the medication, as I saw little if any benefit to her. And, I agree with BarbBrooklyn. Why would I want to slow things down? She has no quality of life. I can see how someone who is young and in early stage might approach this differently.
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harryp Mar 2019
Thank you. I am also concerned about the bowel issue, as mother has had delicate bowels for much of her adult life, and also has a history of ulcers, which is one more reason the Aricept was disastrous for her. My mother's quality of life is such that, her passing relatively soon will be a blessing to her. So thank you and Bless you...
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Harry; I'm not at all sure about your connection with Choline and acetylcholine, but here's what my take on these Alz slowing drugs are, and how we proceeded with my mom.

The evidence is scant that they actually slow the progress. In some patients, they seem to have a beneficial effect on mood.

My mom was the sort who was prone to every side effect known to man, mostly GI ones. In addition, having diarrhea was a lifelong terror to her; it really sent her over the edge.

Mom was already on anti anxiety and anti depression meds which stabilized her mood; we passed on the Alz meds, especially since my mom had Vascular Dementia, and not Alz. The doctor didn't push very hard in our case.

My underlying question, never uttered by me, was "why do you want to slow this down?"
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harryp Mar 2019
Thank you. 'Why would you want to slow this down' is the operative question. Sometimes I wonder how much of this is a somewhat narcissistic desire on the part of the medical community that is more about them than the patient. Thanks so much for your thoughts and insight. Bless you.
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