Weighing All the Options in Dosage Decisions

Leah Health Guide
  • My neurologist visit was a good one. I met with his PA, a man whom I had seen at my Primary Care Physician's office for years prior. He had moved over to a new job at my neurologist's office. It was good to see a familiar face. Mr. J was very thorough in his exam, and we worked as a team to determine whether or not to add or change medications. I did have some concern that my short term memory is getting a little worse, but I decided to hold off increasing Aricept to the 23 mg dosage. Mr. J mentioned that, hmmm, stomach issues increase...


    Since I have been having a great deal of heartburn lately, I figured I wouldn't take the chance. Let me tell what my research on the Aricept site has shown me.

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    First, Aricept, (Donepezil HCI) is given to people with mild to severe Alzheimer's or other types of dementias. The dosage starts out with 5mg once a day. The other dosages are 10mg and 23mg. According to the Prescribing Information, the most common adverse reactions in clinical studies of Aricept are:

    • Nausea
    • Diarrhea
    • Insomnia
    • Vomiting
    • Muscle cramp
    • Anorexia


    However, once one gets into the 23mg dosage, many more people experienced nausea and vomiting than they did using the 10mg dosage. These side effects, however, were found to lessen over time. However, there was an increase in stomach ulcers, gastrointestinal bleeding, and weight loss.


    Back to my doctor visit...


    Mr. J asked me a bunch of questions like, who is the President, what day is it, what month, what city are we in...etc. And, as usual, I could answer them...some with a bit of hesitation, but I still could figure out the answer. The one about the date, well, just five minutes before I had asked the receptionist, written it down, and repeated it. So, my overall memory is still doing pretty well. It's the short term stuff...like when I try to cook from a recipe, or trying to remember if I put the checkbook my husband gave me into my purse, or if I took my pills just minutes before... These types of memories are getting more difficult-but NOT more difficult enough that I want to take a chance on using Aricept 23mg each day and having MORE gastrointestinal problems!


    And so it is with all medications you use or you give your loved ones. One must always consider side effects. Let's face it-most of us will NOT be affected in an adverse way. But one must always weigh the pros and cons before using new medications. As good as Aricept has been for me and my memory, I'm sure there might be something else out there I might try before asking to up the dosage... As a matter of fact, just waiting to see if my memory problems even themselves out as life quiets down will even help! (Our family is grieving over the loss of my eleven year old nephew due to a brain tumor, and we've just found out that my oldest brother has an aggressive form of bladder cancer...so it is not wonder, with this all on my mind, that my memory may be acting up!)


    Audrey Hepburn once said,
    "I heard a definition once: Happiness is health and a short memory! I wish I'd invented it, because it is very true."


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    Life can be so short...take it and run as long as you can! Don't take yourself or your situation tooooo awfully seriously. Look outward. Help others. And do your research to get all the information you can in order to be the best patient advocate for yourself!


    God bless!

Published On: March 12, 2012