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What to Do If the Alzheimer Medications Don't Work

David Roeltgen, MD
David Roeltgen, MD
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Neurologist, Professor

A neurologist for over 20 years, Dr. Roeltgen's passions include...

David Roeltgen, MD

Wednesday, January 17, 2007
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I hope everyone enjoyed the holiday season and is off to a nice 2007. Today, I would like to discuss a common question asked during visits, "The medicine isn't working, should we stop it?"

Commonly, persons diagnosed with mild or moderate Alzheimer's disease are started on Aricept, Exelon or Razadyne (formerly Reminyl) with or without Namenda. After a suitable period of time and a gradual increase to the maximum (or maximally tolerated dose), the patient and family return to see the doctor. Statistically, only about 10% of persons with Alzheimer's disease show improvement from taking the medication. Therefore, it is common for the patient or family to ask the doctor, "Should the treatment be stopped?"

It is important for all to know what the expectations should be when using these medications. The results from the research on these medications are all quite similar. The results from these research studies show that using the medications should maintain the current status of thinking, memory and ability to do daily activities for some time after the treatment is initiated. Therefore, if a person is treated, that person and the family should see a stabilization of function for a period of time. This period of time varies from person to person.

Therefore, the answer to the question posed at the start of this blog is typically, "No." However, there are individual exceptions to this that can arise because of side effects or other problems. In most circumstances, though, the medication is continued.
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This video animation shows how beta amyloid plaques are created in Alzheimer's patients and how they affect the progress of the disease.

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