As a geriatric care manager, the topic of whether to try medications to stop the progression of Alzheimer’s Disease often comes up for discussion. From an evidence based perspective, I have not been impressed with the effectiveness of Aricept, Namenda and other medications in this group. A recent article appeared in the online newsletter, Consumer Report Best Buy Drugs that specifically addresses this question. I share the article with you. Their bottom line is after three months, if there is no improvement, the medication should be stopped.
Alzheimer’s disease gradually destroys the brain, robbing people of their ability to remember, complete everyday tasks, and function on their own. Sadly, drugs to treat the disease, including Aricept and Namenda, don’t work well. And even when they do, it’s only in a few people. Since there are no other options, some will want to try these drugs anyway, but it’s a gamble most people won’t win. That’s why our new CR Best Buy Drugs report on Alzheimer’s medications doesn’t recommend any of them as Best Buy picks.
Our decision, in part, is based on a recent large-scale analysis by the federal Agency for Healthcare Research and Quality (AHRQ), which found these drugs don’t delay the onset of Alzheimer’s or improve or maintain the mental function of people who already have it. The American College of Physicians and the American Academy of Family Physicians, and another review of Alzheimer’s studies in 2007, reached similar conclusions.
Besides not being very effective, Alzheimer’s medications can have side effects too. While most caused by the drugs are relatively minor, such as nausea, vomiting, dizziness, loss of appetite, muscle cramps, tremors, and weight loss, they could be potentially debilitating to older people. In rare cases, the drugs can also cause a slowed heart beat, gastrointestinal bleeding and ulcers, and possibly convulsions or seizures.
In addition, the drugs are expensive. An average monthly prescription ranges from $177 to more than $400. Last year alone, Americans and their insurance companies spent nearly $3 billion on these medications, according to figures from IMS Health, a company that tracks pharmaceutical data.
No currently available Alzheimer’s drug provides much, if any, improvement, and all can cause side effects. Still, if you feel compelled to try a drug to help someone you care for, you could consider donezepil (Aricept) or galantine (Razadyne). Neither works better than other Alzheimer’s drugs, but they might be somewhat better tolerated and are available as low-cost generics. Regardless of which drug you use, stop after three months if you don’t see any improvement.