A reader sent me an email asking about Aricept and Namenda and some other issues. After typing out this response I thought I would publish it as an article...By Bob DeMarco
Alzheimer's Reading Room
Feel free to comment, add insight, or ask additional question. Use the comments box below this article.
Let me start by saying, I was very impressed by your email. You clearly care and are doing everything you can.
Lets start with the combination of Razadyne and Namenda. I am not familiar with the side effects of Razadyne, and I have not investigated how Razadyne and Namenda interact. So I can't be much help on this issue.
On Namenda. There are problems with Namenda for some patients. It does not work effectively for everyone.
On the combination of Aricept and Namenda. I have information on the website concerning the combination and the side effects. High quality research shows that combination of Aricept and Namenda can work well and effectively together.
I am not a doctor so I can't advise you on switching from Razadyne to Aricept. Off the top of my head it doesn't seem like there would be a problem unless there are withdrawal problems coming off Razadyne. I think that would be the only issue.
We did have problems with constipation even before my mother was on Namenda. Much of this problem was caused because my mother just wouldn't go, and when I would suggest that she should go, she would tell me she already did. I remember the days when she would go in there every ten minutes for hours and nothing would happen (before the prune juice solution).
Most days after my mother has a bowel movement I feel like my favorite football team just scored a touchdown. After more than six years it still makes me feel happy.
One time, early on, we had a bad accident and my mother exploded in her bed (I had to give her the citric magnesium). When I told my sister she was horrified. She said, it must have been horrible. I told her, I was so happy she went it was not horrible, it was wonderful. I thought I was going to have to take her to the emergency room.
Eventually, I solved the "dreaded bowel movement" problem with prune juice. If my mother does not have a bowel movement for a day, then I give her two "shots" of prune juice the next day. About 3 ounces at a time. I give the prune juice at the same time each day. Then I keep a close eye on her for the next 20-60 minutes to see if it worked.
We do have some minor problems from time to time. For example, she might not make it to the bathroom on time. The accident is usually minor. This usually happens if I had to give her two shots. Some people use stool softeners or laxatives. We don't. I don't want to add anything to the Alzheimer's drugs that is not absolutely necessary. However, I have never read that stool softeners are a bad thing.
My mother does not wear a diaper and I did solve the problem of urinary incontinence. I make sure my mother goes every two hours without fail. She doesn't wear a diaper to bed either. However, somehow she still gets up at night and goes. If we have a problem it is only a "dampness problem". I can say this, if my mother says, "I have to go", it is usually too late. However, since I usually have her down to an almost empty tank, not much of a problem.
We did not have any problems at all with Namenda in terms of side effects or confusion. I want to say this. You really can't tell about a medication until the patient is on it for 4-6 weeks. Sometimes patients need time to adjust, it often takes time for the medication to start working -- in other words kick in.
Constipation is a side effect of Namenda. We already had the prune juice solution before my mother started on Namenda.
I am comfortable in saying that Aricept worked for us, and that the combination of Aricept and Namenda worked for us. However, I am also convinced that exercise was an important variable for us. I take my mother into a gym. She walks on a treadmill and I work with her on the weight machines. Diet does and can make a difference with bowel movements. We eat a lot of fish and lots of broccoli and spinach. We eat Fiber One cereal, oatmeal, and of course my mother loves eggs.
On the MMSE. I have very little confidence in the test. First and foremost, it is not very good in diagnosing Alzheimer's. The research shows it only works 50 percent of the time -- its like flipping a quarter. There all kind of factors that can effect the test results. For example, the amount of light in the room can effect the score. The person administering the test can effect the score and the list goes on and on.
On some days my mother seems really with it, on other days she is not there, this would effect her test score.
All Alzheimer's patients "slip" as they go. So it is very difficult to know if its the medication or nature taking its course.
My mother does not close the door when she is "going to the bathroom". She will also walk in front of me naked without reaction. Many Alzheimer's patients lose their inhibitions. My mother takes her dentures out, and sometime she eats with her fingers.
It is very difficult to know how any Alzheimer's drug is working. The reason is simple -- there is no way to know how they would have been without the drug. Plus, you have to wait 4-6 weeks when they come off a drug to know if it stopped working.
A few points. I would consider that you get "daddy" a B 12 shot each month. Make sure he is getting a lot of Vitamin D. The pills work. Sunlight is good.
It doesn't sound like he is in a dark mood -- but I usually suggest a good check of the thyroid.
I'm big on the multiple vitamin, vitamin E, oranges, apple juice, grape juice, cinnamon, and making sure we ingest lots of antioxidants.
This list from Dr Oz is good.
Drugs for Alzheimer's disease are expensive. However, Aricept is going generic sometime after November.
You have to beat on the doctors for samples, ask and ask and ask. Sometimes I think, I would like to marry the drug rep for Forest Labs (Namenda).
For the first time in years we avoided the "doughnut hole" this year.
Hope this helps.
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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,690 articles with more than 70,000 links on the Internet. Bob resides in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room