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Alzheimer's Disease

Changing Medications

11/29/2000

Question:

My mother was diagnoised with AD in March of 97. She`s been taking Aricept 10mg since 1997. Her neurologist recommended switching to exelon. She`s able to walk, converse very little, tremors, eats on her own, doesn`t recognize her sons 90% of time. The biggest problem is diarrhea, but it is being handled. I don`t particularily want to switch based on what I`ve read, seems exelon has more adverse side effects. Any recommendation. Age 70.

Answer:

Hello and thank you for submitting a question to us! We hope you find the following information provided by Dr. Geldmacher helpful and useful. "At a drug-specific level, if she is having diarrhea on Aricept, I would be very hesitant to recommend Exelon, which has a higher frequency of more severe GI problems. However, a bigger set of questions revolves around the issue of whether an individual at this severity of Alzheimer's disease should be taking any anti-dementia drugs. This is often as much a personal, social, or faith-based decision as it is a medical one. Discontinuing therapy is always difficult, but it may be useful to consider questions like these: If she is not recognizing her closest family members, what benefit are you seeing from the medicine? Is that benefit worth the discomfort of the diarrhea? When she was well, would she have wanted to be sustained at this level of disability by medicines, or would she have wanted "nature to take its course"?" Thanks again for sending us your question. If you have any other questions, please let us know.

Related Resources:

Memory and Cognition Center

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Response by:

Paula K Ogrocki, PhD Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University

David   Geldmacher, MD David Geldmacher, MD
Formerly, Assistant Professor of Neurology
School of Medicine
Case Western Reserve University