When to stop Aricept?

My husband was recently taken off Aricept and it hasn't seemed to make much difference. He was nodding off in the daytime and still does. He was taking it for the dementia aspect of PSP rather than Alzheimer's.

I feel it is the disease rather than the Medicine. Look up Teepa Snow she is an amazing renown expert on Dementia's.

Yes my husband was on it for about 6 years and recently went off. The Doctors take them off when it no longer makes a difference. Your dad no longer needs it, I would think!

Aricept has questionable results (I'm a medical writer who does research) and all drugs have side effects. Your father's doctor should take him off the drug (in tapered doses if necessary) as soon as possible, as he deserves full quality of life, without any side effects, for the rest of his days. Be warned that many physicians are too happy to keep patients on drugs they don't need. I'm not saying your father's doctor is one of them, I'm just saying you might confront reluctance, but if he or she can't back it up with evidence, then keep making the argument for side effects.

My husband is 76 and has vascular dementia. Basically he is doing OK but his doctor took him off aricept a couple of months ago. He had been on it for years and we felt it was no longer helping. He had no problems coming off of it.

It's not Aricept it's Alzheimer's.
Aricept is a cure it helps slow down the progression of the disease. Western medicine says to add Namenda with the Ariicept. The combination helped my mom...however, she took supplements. ..folic acid, fatty omega 3, alpha lipoic acid and vitamin E along with acupuncture and acupressure.

My answer was supposed to say Aricept is NOT a cure.
Alzheimer's is progressive
It only gets worse.

Has the physcian discussed hospice as an option? It sounds very scarry however, there is no limit to the number of times patients can go on and off of hospice (if they improve).

My father had moderate vascular dementia then he had a ceptic infection which caused his dementia to worsen dramatically and quickly. During his hospital stay, the Dr. placed him on aricept however it didn't seem to help.

The one thing that bothers me is that I wished that I had placed my dad on hospice much sooner. The hospice nurses are very kind and focus on quality of life.

LorrieB,
You are NOT a physician and you have no standing to say what the doctor should do. As a knowledgeable writer, you should know better. It is likely that the Aricept is no longer providing much benefit. Current standards of practice routinely tape off Aricept once deterioration speeds up. By the way, Aricept is not generally indicated in the treatment of vascular dementia. It is a cholinesterase inhibitor. Hence, since vascular dementia is caused by the loss of functional brain matter rather than dysfunctional choline metabolism, Aricept would do nothing helpful. That being said, elderly people might have both vascular and Alzheimer's disease. In that case, Aricept may have been useful.

Though she's lucid and can still drive, cook, etc. (a good thing because i can't do either from my wheelchair), she is getting forgetful, losing her way without me, etc.
Hearing this story a year ago, our doctor put her on Namenda and Aricept. What I've read on this site has convinced me to take her off the Namenda, but to keep the Aricept. I'll ask the doctor about it when I see her next week. She may insist that we continue Namenda, or perhaps decrease the dosage of one or the other. I haven't seen any effects from either drug, but they may have at least slowed her progression into dementia. Her 3-years-older sister is in an institution with full-blown Alzheimer's; their mother was pretty demented at the end of her life, and my wife says that her maternal grandmother also had dementia. Scary.

I DECIDED TO TAKE MY MOTHER OFF ALL HER MEMORY PILLS AND BELIEVE ME IT WAS A COMPLETE TURNAROUND FOR THE BETTER. SHE DOES NOT SLEEP VERY MUCH NOW , AND SHE CAN FEED HERSELF , EVEN DRESS HERSELF. SHE DOES NOT TALK A LOT , AND DOES NOT REMEMBER THINGS BUT SHE IS A LOT BETTER .THAN BEFORE.

I'm not a doctor and I'm not a medical writer, but I sometimes felt I was professional researcher as I cared for my husband with Lewy Body Dementia for 10 years. His doctor was an LBD researcher of international renown at Mayo Clinic.

From my reading and attending conferences and discussion with the doctor, here are my opinions:
1) In spite of all the hype when it was first introduced, Aricept does not delay the progress of ALZ. An extended study in England found no difference in the length of time before institutionalization between the patient who took Aricept and those who did not. At an all-day conference co-sponsored by Mayo and the Alzheimer's Association, last year, the speaker on progress with dementia drugs said flat out that we have no drugs that delay the progression.
2) Sometimes Aricept makes an improvement right now -- not down the road. If that is the case, hooray! If you are not seeing some actual improvement it probably isn't worth continuing to take it in the hope that is somehow slowing the progress.
3) Aricept was developed for and approved for use with Alzheimer's -- not any of the 50 or so other dementia diseases. But many patients have Alzheimer's as well as some other kind of dementia. Trying it may still be appropriate.
4) LBD often responds better to Aricept than the dementia it was developed for. My husband took Aricept with good results. As the years went by his doctor often said it might not still be helping but that since Hubby was doing so well he hated to "rock the boat" by discontinuing it. Almost all of his drugs were discontinued on hospice, but then we added back both Aricept and Seroquel, and adding them back resulted in visible improvement in delusions and agitation.

DoctorJC, I appreciate your participation on these boards. Your information about Aricept and vascular dementia is a good contribution.

LorrieB, I appreciate you stating your profession. Anyone reading your post would know that you are not a doctor.

But very, very few of us on these forums are doctors. This is not a site for professionals to discuss with other professionals We are overwhelmingly lay persons. And each of us is entitled to express our opinions. We might even give an opinion about what we think a doctor should do. We very often give the opinion that someone should talk to their doctor (or change doctors).

DoctorJC, I know that not all posts here contain accurate information. And I REALLY appreciate it when someone more knowledgeable offers corrections. But I certainly don't appreciate seeing a fellow poster being told she "has no standing" to express an opinion. None of us have "standing." All of us have experience and questions and opinions.

My hairdresser can give me an opinion of what my doctor should do. He doesn't have to have "standing" to give me that opinion. Since I know he is a hairdresser I don't blindly take his advice. That is why it was good that Lorrie listed her profession.

Am supportive of your opinion Jeanne!

After reading so many posts about Namenda on this forum, I decided to stop giving it to my wife, but I'm still waiting for our doctor to tell me whether that is the best way to go. Someone asked If she can drive, cook, shop, and do email, why on earth is she taking Namenda and Aricept?" I guess it's because our internist ordered those drugs the minute we told her about mild instances of confusion, like driving 40 miles east when she was supposed to go 2 miles west--with her phone dead but not plugged into the charger in the car. Maybe stopping Namenda will make it even worse? Unfortunately, I can't drive for various physical reasons.

Jeanne
My comment to Lorrie were based on her statement ," Your father's doctor should stop the medicine as soon as possible." That is a medical statement rather than a simple opinion. I am careful not practice medicine on this website. I hope to be helpful with some medical facts and science while also sharing my experience as a caregiver. I have no problem with informed opinions.

thanks for all the posts, I am going to try to contact the doctor since I haven't heard back from the nurses at the NH on the matter. But before my father was on anything, he would get frustrated and angry so much at time that he would literally pick up his walker above his head (when lying down) and shake it (per my mother). so I don't think taking him off everything is wise. they also have him on some anxiety meds which I think are helping. but at 92 (almost 93), I know the Aricept is no longer working OR maybe never did. He was awake the other day when we stopped in and he was talking about getting some flapjacks. so there are good days and bad days........

Thank you to those who defended my right to have an opinion. I have worked with many, many physicians during my career, so perhaps my experience is one step up from the hairdresser, whose opinion is also valid, by the way! If I was forthright with my advice, it's only because the patient is 92 and the pill (as stated by Wolflover) is "no longer doing anything." The decision had already been made, in other words. DoctorJC, I'm sure you're a good doctor who would never leave an elderly patient on a drug that was unnecessary, but I hope you're not trying to tell us that this never happens, because I can prove that it does and am quite happy to do so, in a separate communication. This is a site to help caregivers deal with situations, and one of those situations is the discussion of "to drug or not to drug." I take your point about the wording of my advice, and will try not to step on your toes in future.

Every post I've seen has been about Aricept. How about Namenda? Since my wife can still drive, cook, do laundry, &c., some have suggested that it's not time yet for Namenda, and that she shouldn't take it until the Aricept needs more of a boost. Pending an answer from our internist, I'm about to take her off the Namenda for a few weeks to see if there's any difference.