Although there is no cure for Alzheimer’s Disease, there are currently medications available which slow the disease progression. The two most commonly used are Aricept and Cognex. Cognex was the first medication approved in the United States to treat mild to moderate symptoms of Alzheimer’s Disease. Early studies in 1986 reported marked improvement in cognitive status. It is important when subscribing this medication to start with small doses and increase the dose after four to six weeks.
As with any medication, there can be side effects. Patients on Cognex must have weekly blood tests for eighteen weeks, then every three months after that. This medication can cause liver damage, nausea, vomiting, diarrhea, and decreased appetitite. Only one-third of patients on this medication show improvement, others will cognitively stay about the same. When the medication is discontinued, symptoms of Alzheimer’s Disease will worsen. The cost, including blood tests, doctor visits, and the medication amounts to $2500-$3000 per year. (Hamdy et al., 1998).
In November 1996, Aricept became available. Taking this drug does not require having periodic blood tests. This medication should also be started with a small dose. Studies show that patients with mild to moderate symptoms of Alzheimer’s Disease may exhibit cognitive improvement for up to two years while taking the medication. There are no studies available beyond this. Side effects are nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and anorexia. This drug also causes problems for patients who have stomach ulcers. (Hamdy, et al., 1998).
Although these most common medications slow or stop the progression of Alzheimer’s Disease for a time, neither drug can change the inevitable progression of Alzheimer’s Disease. (Hamdy et al., 1998). Medication and Difficult Behaviors There are many medications available to manage behavior problems which often accompany people with Alzheimer’s Disease or a related dementia. Aggression, restlessness, delusions, hallucinations, and inappropriatesexual behavior are often treated with antipsychotic drugs. The most commonly used, with the least side effects are clozapine, risperdone, and olanzepine. Clozapine requires weekly blood tests. Possible side effects are dry mouth, constipation, orthostatic hypotension, tremors, restlessness, muscle cramps, seizures, and photosensitivity. (Hamdy et al., 1998).
Anxiety and insomnia is common with people with Alzheimer’s Disease. Benzodiazepines work well with these behavior problems. These drugs are fast-acting and rapidly eliminated which is preferable with the elderly. Types of these drugs are alprazolan, lorazepam, and triazolam. (Hamdy et al., 1998). Depression is common with early stages of Alzheimer’s Disease. Other medications must be considered when an antidepressant is going to be added. The family history may be important. If a medication for depression has worked well on a family member, it would be safe to try on the patient with dementia. It is always best to start with a low dose and slowly increase it. Side effects may be orthostatic hypotension, cardiac irregularities, skin rashes, and liver toxicity. (Hamdy et al., 1998).
Rights of People With Alzheimer’s Disease All people should be treated equally, all people should have a voice in their care, all people should be treated with respect and integrity. People with Alzheimer’s Disease are no different. Although they have cognitive impairment and need supervision as the disease progresses, they should always be treated with respect and dignity. (Department of Human Services, Resident Rights, 1997). Alzheimer’s Disease and related dementias continues to be researched. More and more is being learned every year. Education regarding medications, and caregiving needs to be ongoing to provide this population the care and respect the population deserves to have.
Alzheimer’s Association. (1997). [On-line]. Available: http://www.alz.org/mission/mission.html
Alzheimer-Europe. (Undated). [On-line]. Available: http://www.alzheimer-europe.org/frrbot0l.html
Alzheimer Test Dilemma. (1995). (On-line). Available: http://www.pathfinder.com/time/magazine/archive/1995.
Department of Human Services. (1997). Resident Rights.