Alzheimer’s Disease: Should I Take Medicines?

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Alzheimer’s Disease: Should I Take Medicines?

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Alzheimer's Disease: Should I Take Medicines?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's Disease: Should I Take Medicines?

Get the facts

Your options

  • Treat Alzheimer's disease with medicines for as long as they
    are helpful.
  • Don't take medicines. Try other ways to improve thinking and
    memory and to reduce confusion.

Key points to remember

  • Medicines can't cure
    Alzheimer's disease, but they can slow it down for a
    while and make it easier to live with. They may relieve symptoms such as having
    trouble thinking and remembering things.
  • Medicines may not work
    for everyone. Even if they do work, they may not make a big difference in how
    you think and remember.
  • Medicines may cost a lot. You can try
    taking them for a while to see if they help and if that help is worth the cost
    to you.
  • These medicines have side effects, but many people are
    able to take them without problems. Side effects can include nausea, diarrhea,
    vomiting, belly pain, weight loss, and lack of hunger.
  • Some people
    with Alzheimer's disease are able to keep up their daily activities for many
    years, even if they do them at a reduced level or in different ways. If you
    decide not to take medicine, you can help yourself by scaling back on
    activities to match your abilities. You can also try scheduling activities
    during the times of day when you can best handle them.
FAQs

What is Alzheimer's disease?

Alzheimer's disease damages the
brain. It causes a steady loss of memory and affects
how well you can speak, think, and do your daily activities.

Alzheimer's disease gets worse over time, but how quickly this
happens varies. Some people lose their ability to do daily activities early on.
Others may do fairly well until much later in the disease. As the disease gets
worse, you may:

  • Have trouble making decisions.
  • Be confused about what time and day it is.
  • Get lost in places you
    know well.
  • Have trouble learning and remembering new
    information.
  • Have trouble finding the right words to say what you
    want to say.
  • Have more trouble doing daily tasks like cooking a
    meal or paying bills.

What medicines are used to treat Alzheimer's disease?

Medicines can't cure
Alzheimer's disease. But they can slow down the way it
affects your brain and make the disease easier to live with.

  • Cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) are
    the most commonly used medicines for Alzheimer's. They can boost memory and the
    ability to do daily activities. They can be used in all stages of the disease.

  • Memantine (Namenda) can relieve
    symptoms of memory loss, confusion, and thinking problems. It may help you in
    the middle and late stages of the disease, when your symptoms are severe. You
    may take this medicine alone or with cholinesterase inhibitors.

Other medicines may be used to help with anxiety,
agitation, anger, or other symptoms like these.

Medicines may not
work for everyone. Even if they do work, they may not make a big difference in
how you think and remember. Over time, as your disease gets worse, medicines
will stop working. The long-term effects of these medicines are not known.

What are the side effects of these medicines?

Most
people are able to take these medicines without problems. Most side effects go
away within a few weeks after you start taking the medicines.

The
most common side effects of cholinesterase inhibitors
are:

  • Nausea (feeling sick to your
    stomach).
  • Diarrhea.
  • Vomiting.
  • Upset stomach
    (indigestion).
  • Lack of
    hunger.
  • Weight loss.

Other problems are less common. You may feel very tired,
have trouble sleeping, or have muscle cramps.

Common
side effects of memantine are:

  • Dizziness.
  • Confusion.
  • Headache.
  • Trouble moving your bowels
    (constipation).

It's important to have regular visits with your doctor
while you are taking these medicines. As the disease gets worse and symptoms
change, your medicines or doses may change too.

If you are caring
for someone who has Alzheimer's disease, watch for problems or side effects from
medicines.

What can you do to help yourself without taking medicines?

If you have been diagnosed with
Alzheimer's disease, you may feel angry, frightened,
depressed, and worried about the future. Even though
the disease gets worse over time, some people are able to keep up their daily
activities for many years, even if they do them at a reduced level or in
different ways.

Try some of these ways to cope, with or without
medicines:

  • Scale back on
    activities to match your abilities. A task may take longer than it used to, but
    if you want to keep doing it, you should try. Make changes as needed. For
    example, if you no longer feel comfortable cooking, think about other things
    you can do, such as shopping and meal planning or setting the table. Or try
    using simpler recipes.
  • Schedule activities
    and tasks for the times of day when you're best able to handle them. It may
    help to have a routine that doesn't change much from day to day.
  • You or your caregiver can help
    avoid confusion at home by labeling often-used rooms
    and objects.
  • Before you go out alone, write
    down where you are going, how to get there, and how to get back home. Do this
    even if it's a place you have gone many times before. Take someone else along
    when you can.

Talking with people who know about Alzheimer's can help by teaching you about the disease and how to cope. Contact Alzheimer's organizations, look for community services, and attend support groups to learn as much as you can.

Why might your doctor recommend medicines?

Your
doctor may recommend that you take medicines for Alzheimer's if:

  • Medicines will make it easier for you to do
    daily activities.
  • Medicines will reduce your symptoms and make it
    easier for others to take care of you.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Take medicines for
Alzheimer's disease

Take medicines for
Alzheimer's disease

  • You take pills every day for as
    long as they help your symptoms.
  • You see your doctor regularly to check how well the medicines are
    working. As the disease gets worse, you may want to try a different medicine,
    dose, or combination of medicines.
  • Your memory and ability to think
    clearly may get better for a short time.
  • Medicines may slow down
    the effects of the disease. You may be able to stay independent longer.
  • Medicines may not
    help everyone who has Alzheimer's disease.
  • Medicines can't cure the
    disease. Over time, medicines will stop working.
  • Medicines can cost
    a lot.
  • Side effects include:
    • Diarrhea.
    • Vomiting.
    • Upset
      stomach.
    • Lack of hunger.
    • Weight
      loss.
Don't take medicines

Don't take medicines

  • You or your caregiver can
    try other ways to
    reduce confusion, such as labeling often-used rooms
    and objects.
  • You can try other ways to cope with the disease, such
    as scaling back on tasks to match your abilities.
  • You avoid the cost and side
    effects of medicines.
  • If you are not able to cope on your own, you can try medicines
    later.
  • You may not
    be able to cope with your symptoms without medicines.

Personal stories about taking medicines for Alzheimer's disease

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

As long as
I'm doing all right, I would like to stay off of medicines. Some days it's
really hard, because I get confused and even frightened. But I don't tolerate
medicines that upset my stomach very well, and I'd like to stay feeling as
well as I can until my disease progresses. My wife knows to put me on
medicines if I become violent or if my behaviors become burdensome to her.

Jed, age
62

I was just diagnosed as being in the early
stages of Alzheimer's disease. I'd like to remain as mentally clear as I
possibly can for as long as I can. I'm going to try taking a cholinesterase
inhibitor called Aricept, because it may help delay the this condition
for a few more months. Even though that's not a long time, every day is
precious to me.

MaryAnne, age 74

My wife, Sally, left instructions that she
would like to be put on medicines if her personality changes and memory loss
become a burden for me. Her memory loss and thinking problems have become
severe, so her doctor has prescribed a new type of medicine called memantine
that might reduce these symptoms. Even though no medicine will prevent the
disease from progressing, I want to keep my Sally with me for as long as I can.

Joel, age
81

Fred, who is 77, is in the later stages of
Alzheimer's disease. He was taking cholinesterase inhibitors and then memantine
for several years with good results. But his body is no longer responding
to the medicines. He is incontinent, and the medicines give him diarrhea.
My sons and I have decided it's time to take Fred off the medicines and let
the disease run its course.

Harrietta, age 73

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines to treat Alzheimer's disease

Reasons not to take medicines

I want to keep doing my daily activities as long as I can, even if it means taking medicines.

I want to keep doing my daily activities without relying on medicines.

More important
Equally important
More important

I think taking medicines will help me stay independent longer.

I don't think taking medicines will make a difference in how independent I am.

More important
Equally important
More important

The cost of the medicines doesn't bother me.

I'm worried about the cost of the medicines.

More important
Equally important
More important

I can deal with the side effects of these medicines.

I'm worried about the side effects.

More important
Equally important
More important

Even though medicines may not work for me, I still want to try them.

I don't want to try medicines if they aren't going to work.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Do medicines make a big difference for everyone with Alzheimer's disease who takes them?
2, Can medicines cure Alzheimer's disease?
3, Do most people who take medicines have problems with side effects?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure


Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits

Credits
Author Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Myron F. Weiner, MD - Psychiatry, Neurology
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Alzheimer's Disease: Should I Take Medicines?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Treat Alzheimer's disease with medicines for as long as they
    are helpful.
  • Don't take medicines. Try other ways to improve thinking and
    memory and to reduce confusion.

Key points to remember

  • Medicines can't cure
    Alzheimer's disease, but they can slow it down for a
    while and make it easier to live with. They may relieve symptoms such as having
    trouble thinking and remembering things.
  • Medicines may not work
    for everyone. Even if they do work, they may not make a big difference in how
    you think and remember.
  • Medicines may cost a lot. You can try
    taking them for a while to see if they help and if that help is worth the cost
    to you.
  • These medicines have side effects, but many people are
    able to take them without problems. Side effects can include nausea, diarrhea,
    vomiting, belly pain, weight loss, and lack of hunger.
  • Some people
    with Alzheimer's disease are able to keep up their daily activities for many
    years, even if they do them at a reduced level or in different ways. If you
    decide not to take medicine, you can help yourself by scaling back on
    activities to match your abilities. You can also try scheduling activities
    during the times of day when you can best handle them.
FAQs

What is Alzheimer's disease?

Alzheimer's disease damages the
brain . It causes a steady loss of memory and affects
how well you can speak, think, and do your daily activities.

Alzheimer's disease gets worse over time, but how quickly this
happens varies. Some people lose their ability to do daily activities early on.
Others may do fairly well until much later in the disease. As the disease gets
worse, you may:

  • Have trouble making decisions.
  • Be confused about what time and day it is.
  • Get lost in places you
    know well.
  • Have trouble learning and remembering new
    information.
  • Have trouble finding the right words to say what you
    want to say.
  • Have more trouble doing daily tasks like cooking a
    meal or paying bills.

What medicines are used to treat Alzheimer's disease?

Medicines can't cure
Alzheimer's disease. But they can slow down the way it
affects your brain and make the disease easier to live with.

  • Cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) are
    the most commonly used medicines for Alzheimer's. They can boost memory and the
    ability to do daily activities. They can be used in all stages of the disease.

  • Memantine (Namenda) can relieve
    symptoms of memory loss, confusion, and thinking problems. It may help you in
    the middle and late stages of the disease, when your symptoms are severe. You
    may take this medicine alone or with cholinesterase inhibitors.

Other medicines may be used to help with anxiety,
agitation, anger, or other symptoms like these.

Medicines may not
work for everyone. Even if they do work, they may not make a big difference in
how you think and remember. Over time, as your disease gets worse, medicines
will stop working. The long-term effects of these medicines are not known.

What are the side effects of these medicines?

Most
people are able to take these medicines without problems. Most side effects go
away within a few weeks after you start taking the medicines.

The
most common side effects of cholinesterase inhibitors
are:

  • Nausea (feeling sick to your
    stomach).
  • Diarrhea.
  • Vomiting.
  • Upset stomach
    (indigestion).
  • Lack of
    hunger.
  • Weight loss.

Other problems are less common. You may feel very tired,
have trouble sleeping, or have muscle cramps.

Common
side effects of memantine are:

  • Dizziness.
  • Confusion.
  • Headache.
  • Trouble moving your bowels
    (constipation).

It's important to have regular visits with your doctor
while you are taking these medicines. As the disease gets worse and symptoms
change, your medicines or doses may change too.

If you are caring
for someone who has Alzheimer's disease, watch for problems or side effects from
medicines.

What can you do to help yourself without taking medicines?

If you have been diagnosed with
Alzheimer's disease, you may feel angry, frightened,
depressed, and worried about the future. Even though
the disease gets worse over time, some people are able to keep up their daily
activities for many years, even if they do them at a reduced level or in
different ways.

Try some of these ways to cope, with or without
medicines:

  • Scale back on
    activities to match your abilities. A task may take longer than it used to, but
    if you want to keep doing it, you should try. Make changes as needed. For
    example, if you no longer feel comfortable cooking, think about other things
    you can do, such as shopping and meal planning or setting the table. Or try
    using simpler recipes.
  • Schedule activities
    and tasks for the times of day when you're best able to handle them. It may
    help to have a routine that doesn't change much from day to day.
  • You or your caregiver can help
    avoid confusion at home by labeling often-used rooms
    and objects.
  • Before you go out alone, write
    down where you are going, how to get there, and how to get back home. Do this
    even if it's a place you have gone many times before. Take someone else along
    when you can.

Talking with people who know about Alzheimer's can help by teaching you about the disease and how to cope. Contact Alzheimer's organizations, look for community services, and attend support groups to learn as much as you can.

Why might your doctor recommend medicines?

Your
doctor may recommend that you take medicines for Alzheimer's if:

  • Medicines will make it easier for you to do
    daily activities.
  • Medicines will reduce your symptoms and make it
    easier for others to take care of you.

2. Compare your options

  Take medicines for
Alzheimer's disease
Don't take medicines
What is usually involved?
  • You take pills every day for as
    long as they help your symptoms.
  • You see your doctor regularly to check how well the medicines are
    working. As the disease gets worse, you may want to try a different medicine,
    dose, or combination of medicines.
  • You or your caregiver can
    try other ways to
    reduce confusion, such as labeling often-used rooms
    and objects.
  • You can try other ways to cope with the disease, such
    as scaling back on tasks to match your abilities.
What are the benefits?
  • Your memory and ability to think
    clearly may get better for a short time.
  • Medicines may slow down
    the effects of the disease. You may be able to stay independent longer.
  • You avoid the cost and side
    effects of medicines.
  • If you are not able to cope on your own, you can try medicines
    later.
What are the risks and side effects?
  • Medicines may not
    help everyone who has Alzheimer's disease.
  • Medicines can't cure the
    disease. Over time, medicines will stop working.
  • Medicines can cost
    a lot.
  • Side effects include:
    • Diarrhea.
    • Vomiting.
    • Upset
      stomach.
    • Lack of hunger.
    • Weight
      loss.
  • You may not
    be able to cope with your symptoms without medicines.

Personal stories

Personal stories about taking medicines for Alzheimer's disease

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"As long as I'm doing all right, I would like to stay off of medicines. Some days it's really hard, because I get confused and even frightened. But I don't tolerate medicines that upset my stomach very well, and I'd like to stay feeling as well as I can until my disease progresses. My wife knows to put me on medicines if I become violent or if my behaviors become burdensome to her."

— Jed, age
62

"I was just diagnosed as being in the early stages of Alzheimer's disease. I'd like to remain as mentally clear as I possibly can for as long as I can. I'm going to try taking a cholinesterase inhibitor called Aricept, because it may help delay the this condition for a few more months. Even though that's not a long time, every day is precious to me."

— MaryAnne, age 74

"My wife, Sally, left instructions that she would like to be put on medicines if her personality changes and memory loss become a burden for me. Her memory loss and thinking problems have become severe, so her doctor has prescribed a new type of medicine called memantine that might reduce these symptoms. Even though no medicine will prevent the disease from progressing, I want to keep my Sally with me for as long as I can."

— Joel, age
81

"Fred, who is 77, is in the later stages of Alzheimer's disease. He was taking cholinesterase inhibitors and then memantine for several years with good results. But his body is no longer responding to the medicines. He is incontinent, and the medicines give him diarrhea. My sons and I have decided it's time to take Fred off the medicines and let the disease run its course."

— Harrietta, age 73

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines to treat Alzheimer's disease

Reasons not to take medicines

I want to keep doing my daily activities as long as I can, even if it means taking medicines.

I want to keep doing my daily activities without relying on medicines.

             
More important
Equally important
More important

I think taking medicines will help me stay independent longer.

I don't think taking medicines will make a difference in how independent I am.

             
More important
Equally important
More important

The cost of the medicines doesn't bother me.

I'm worried about the cost of the medicines.

             
More important
Equally important
More important

I can deal with the side effects of these medicines.

I'm worried about the side effects.

             
More important
Equally important
More important

Even though medicines may not work for me, I still want to try them.

I don't want to try medicines if they aren't going to work.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Do medicines make a big difference for everyone with Alzheimer's disease who takes them?

  • Yes

  • No
  • I'm not sure

You're right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.

2.
Can medicines cure Alzheimer's disease?

  • Yes

  • No
  • I'm not sure

You're right. There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.

3.
Do most people who take medicines have problems with side effects?

  • Yes

  • No
  • I'm not sure

You're right. These medicines have side effects, but most people are able to take them without problems.

Decide what's next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2.
Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

 

Credits
By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Myron F. Weiner, MD - Psychiatry, Neurology

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