When a person is diagnosed with Alzheimer’s disease, the prognosis is not a good one. With no cure for the disease, which affects one in 10 people over the age of 65, some turn to drugs that can slow the process of deterioration. Dr. Jimmy Davis, medical director at Talladega Healthcare said family members probably wouldn’t see a lot of changes once the Alzheimer’s patient begins taking treatment.
“There are several medications that are used, but we really don’t have anything in terms of medication that really changes things that much,” Davis said. “It may help stabilize the condition for several months, but there’s not any medication that really changes the course of the disease. It may improve things or stabilize things, but it doesn’t really do that much.”
In addition to dealing with patients who suffer from Alzheimer’s, Davis has seen first hand the impact the disease has on the family of the person diagnosed.
“My mother had Alzheimer’s and died from Alzheimer’s,” he said. “It’s very difficult because the person that you knew they just deteriorate and all of a sudden they look like the person you knew, but you can’t relate to them like you did. They can’t communicate. Over a period of time they lose the ability to eat, swallow. So it’s not the same person that you knew, that you grow up with over time.
“It’s a very slow death. Alzheimer’s is a terminal disease. If you have it, you die of it. Usually the time course may be 10-15 years.”
Help for now
The U.S. Food and Drug Administration has approved five drugs to treat Alzheimer’s disease according to the Alzheimer’s Association’s web site. The most commonly prescribed is donepezil, which is more commonly known as Aricept. The FDA approved the drug in 1996. More than 3.8 million people have taken the medicine, making it the number one prescribed Alzheimer’s drug in the world according to Aricept’s web site.
Aricept is taken once a day and is used to treat all stages of Alzheimer’s. It is a type of drug known as cholinesterase inhibitors, which the FDA approved to treat cognitive symptoms of Alzheimer’s disease. Memory, thinking, language, judgment and other thought processes are affected by cognitive symptoms. Rivastigmine, which is also called Exelon and galantamine, which is called Razadyne, are two drugs approved to treat mild to moderate Alzheimer’s.
Tacrine, also called Cognex, was the first cholinesterase inhibitor and was approved in 1993. The drug has a risk of liver damage as a side effect and is rarely prescribed today according to the Alzheimer’s Association’s web site. With the exception of Cognex, the other drugs approved by the FDA for the treatment of Alzheimer’s disease have relatively minimal side effects.
While the cholinesterase inhibitors are the most popular drugs prescribed to treat symptoms of Alzheimer’s, there is no cure for the disease. Aricept, Exelon and Razadyne are believed to delay or slow the worsening of symptoms in some people for six months to a year.
“Some people take them for six months or a year and if it seems to be helping, they continue,” Davis said. “If they don’t seem like they appear to be working, sometimes they just discontinue, especially if they continue to deteriorate on the medications.”
Another drug, Namenda, which was approved by the FDA in 2003, can be taken with Aricept, Exelon or Razadyne to help treat the disease. While results from the medications are varied, Davis said improvement in some patients might not be because of the drug they are taking.
“Some people progress at different rates,” he said. “Some people stabilize. I don’t think it’s necessarily related to the medication that we use.”
Research
The Alzheimer’s Association continues to search for new medications to treat and ultimately cure Alzheimer’s disease. According to the association’s web site, researchers are studying the effectiveness of nonsteroidal anti-inflammatory drugs on Alzheimer’s patients. NSAIDs are aspirin and similar drugs, which are used to treat inflammation and fever. Researchers are interested in these because informational studies found people who take large doses of the drugs for arthritis and other conditions have a “reduced likelihood of developing Alzheimer’s,” according to the association’s web site. Researchers found that NSAIDs may be more effective preventing rather than treating Alzheimer’s.
Drugs targeting beta-amyloid, a microscopic protein fragment, are being researched as well. Some researchers believe beta-amyloid is the primary cause of Alzheimer’s. No drug targeting the protein fragment has been marketed as of yet.
Davis said not knowing the cause of Alzheimer’s greatly hinders the process of finding a cure for the disease.
“There are some experimental things that they’re working on,” he said. “As you know, it’s a degenerative-type change in the brain. The medication really works on trying to stabilize the transmitters as much as possible, but it doesn’t create any new transmitters.
“I think now we feel like there are multiple factors that cause cancer. I think it may be the same way with Alzheimer’s. I don’t think we’re very close, there’s no real good target to know what causes this disease. We know that with aging, the prevalence dramatically increases.”
While Davis doesn’t have a cure or any idea when one could be found, he does believe one needs to be found soon.
“It’s a disease of the aging although you can get it at an early age,” he said. “It’s a field that needs a lot of research because of the mortality of the disease. I think we can be hopeful, but I don’t have anything right now to indicate that anything has dramatically changed.”
Tips for patients and caregivers
The Alzheimer’s Association recommends patients and/or caregivers understand the use of the medication prior to taking it.
- Tell the physician all drugs the patient is taking so drug interactions can be avoided.
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- Do not change doses without consulting a doctor. Do not exaggerate symptoms in order to persuade the physician to increase dosage or prescribe a new drug.
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- Keep a written record of all current medications, including the name, dosage and starting date.
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- Give the medication at the same time and in the same way each day.
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- Caregivers shouldn’t assume an Alzheimer’s patient would take the medicine on their own.
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- Keep the medicine organized, especially if the patient takes more than one drug. A plastic container or small paper cups can be useful to help keep track of what medicine has been given.
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- Make sure all medications are kept in a locked cabinet or drawer and throw out old medicines.
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- Keep the number of the local poison control center or emergency room on hand and call if you suspect a medication overdose.
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