Currently there are 5 drugs that are/have been used with treatment of Alzheimer’s Disease: Cognex (no longer in use), Aracept, Remeril, Exelon, and Namenda.

Alzheimer’s Disease starts in the hypocampus of the brain. This is the part of the brain that affects mood, instinct and self-preservation, and short-term memory. Thus, some of the first symptoms that show up in a person with Alzheimer’s Disease are related to these three areas. Paranoia, fear of losing control, fear of others knowing you’ve lost control, short term memory loss, repetitive activity, repetitive speech, hypersexuality, loss of sexual interest, appetite suppression and weight loss are all symptoms of the early stage of the disease. As the disease progresses, vision problems and balance can be afftected.

None of the medications at this time can reverse the effects of the disease. All they can do is serve to hold a person at the level they are presently at for a longer period of time, allowing them to live relatively independently longer, thus delaying admission to long-term care.

Acetocholine is the neurotransmitter that transmits information from the cells in the brain to the body as the message moves from one cell to the next. Most of the medicines (Aracept, Remeril, Exelon all called Class 1 drugs) serve to keep acetocholine from breaking down so they can do their job in transmitting messages. Hence these drugs are effective in the early stages of the disease. The biggest assist comes when the person is identified early and treatment begins early. However, often that is not the case as people are prone to deny there is a problem, and delay getting help, or take a wait and see attitude. This often means that when a person finally seeks help, they have lost precious skills that are not retrievable.

One year ago, Namenda was introduced on the market. It is designed for later stages of Alzheimer’s Disease treatment. It works on the calcium-potassium pump in the cells, allowing the cell to better regulate the chemicals. Too much potassium in the cell causes problems. The current strategy is to use Namenda with one of the Class 1 drugs, most commonly Aracept. The cost of this drug combination, however, is more than $200 a month. Ann suggests that if you do not have insurance that covers the cost of the medications, that you get in contact with her, and she will help you identify some possible sources for reduced cost medications.

It is important to note that the drugs do not repair the damage in the brain, they serve only to slow down the progress of the disease. Neither can the drugs stop the progress of the disease. If the person is taken off the drugs, he or she may experience a steep and rapid decline in their functioning level. This is irreversible. On the other hand, when the person is bed-ridden and has lost most cognition, it is the family’s choice whether to continue the drugs or take the person off the meds.

One of the additional manifestations of Alzheimer’s Disease is the possible comorbidity with depression, delusions, or anxiety. There are several psychotropic medications that can be used to treat these problems. Haldol used to be used to treat depression, but because of its side-effects, it has fallen out of favor. More likely to be used are Zyprexia or Seraquil. Also, in the past, anti-anxiety drugs such as Atavan, Buskar, Ambien used to be used, but again have fallen out of favor because of their side-effects. In their place, physicians are now using SSRI’s (seritonin selective re-uptake inhibitors) such as Selexia.

Other points of interest:

1. Less than 3% of the people who have Alzheimer’s Disease have inherited it. Most likely to inherit are those with 2 parents with the disease.
2. Remember the philosophy: The Person with Alzheimer’s Disease is always right. You cannot reason or argue with them, because they most likely cannot learn, and do not remember the lesson you are trying to make with an argument.
3. People with Alzheimer’s Disease need a lot of bright light to help them function better.