My mother, who has mild-moderate Alzheimer's, has been on Aricept for about a year and a half with some apparent benefit and no side effects. Recently I've seen signs that she's slipping (difficulty signing her name, a little more confusion, repeating herself) and her doctor suggested we try a starter pack of Namenda. Her doctor didn't explain much about the medication. She said to take it instead of the Aricept. I'd like some thoughts about whether Namenda is generally used in addition to or instead of Aricept and what the indications for it are. Have people found it helpful?

Rachele

Rachel...please question your doctor again after you have done some research. (See message board for help as well as Google these drugs.) Aricept appears to be effective for about a year then plateaus. Most neurologists would then add Razadyne, which acts like Aricept and Namenda.

You are doing a great job by questioning. There are many people here to help. Happy New Year!

Rachele, welcome to the Alzheimer's Association forums, and much sympathy for what brings you here.

For people who can tolerate Aricept, combining it with Namenda is often tried.

Lots of us can't tolerate the Aricept type drugs, but are fine with Namenda. I take Namenda. It can help, or maybe just slow down the progression of our disease.

Aricept, Razadyne(generic form called galantamine), and Exelon all do basically the same thing--they inhibit an enzyme which breaks down acetylcholine. Acetylcholine is a very important carrier of messages from one brain cell to another.

Namenda prevents the breakdown of glutamate. It is also an important carrier of messages.

Namenda was originally intended for people who had progressed further into dimentia, but is now being given sooner. Normally it is given along with one of the above.

I would suggest that you ask the doctor to prescribe both types of medications. My wife, for example, takes galantamine and namenda.

I don't think it is wise to take only namenda.

John, I take Namenda, but none of the acetylcholine drugs. What about that isn't wise?

I've heard what you're saying about them usually being paired, but I hadn't heard negatives about taking Namenda without the other stuff.

Then again, I might have heard it this morning, just don't remember . . .

My Mom's Primary Care Physician (MD and Geriatric specialist)and Neurologist informed me that since she is now at the "severe stage 6" and was taking only Aricept since 2006. After 2006, then Aricept was combined with Namenda. Now that she is at the later stages of Alzheimer's the doctor's said that Aricept (even though it claims to be for all stages) is really only effective during the early stages (and depending, can be effective from 1 to 4 years, some claim up to 1 year or 12 months). I was told that Namenda is the only approved medication by the FDA that is for moderate to severe stages. Plus if they kept the meds that are used for only early to moderate the side effects become more serious from what I read and was told by the doctor's (especially the Neurologist)..

I hope this helps..

Liz

I hope this helps,

There is a lot of misinformation about how long the AD drugs work. The initial clinical trials were for six months, later trials went a year or so. The drugs worked throughout that time.

For some reason, this got interpreted to mean they stop working. Not so. It's just far too expensive to run a clinical trial for five or six years, and there's no reason to do so, since the drug companies could get approval with the shorter trials.

Now that the drugs have been around for a while, it has been possible to run retrospective studies, comparing, e.g., nursing home residents who did or did not take the meds. On average, the meds were shown to continue working for the length of time that was studied, up to five or six years. We don't know if they continue working after that ... the question hasn't been addressed. (The data hasn't been available ... the drugs haven't been around all that long, after all.)

NOTE, however, that the results are average results. Some patients did better than others. Some patients may not have been helped at all.

And we've all read posts by caregivers whose loved ones improved after the meds were stopped ... just as we've all read posts by caregivers whose loved ones went into a sudden, sharp decline after the meds were stopped.

Re the original question:

Namenda was originally approved for moderate to severe AD. Cholinesterase inhibitors were originally approved for mild AD, although aricept has now been approved for all stages.

So the trend has been to prescribe aricept first, and later add namenda.

Studies have shown that patients, on average, do better on both drugs than on either one separately.

My husband was originally put on namenda only, and he improved quite a bit. Other caregivers have reported the same thing. (And some have reported that their ADLOs had adverse side effects.)

There is nothing inherently "wrong" with having a loved one on namenda by itself.

My mom has been on namenda for the past 5 years. Last week we added aricept. I have seen a big difference. She is now very talkative, seems like she has OCD, very energetic and her memory is slightly improved. Guess time will tell.

Hi, I am new here and was in denial about my mom having dementia.
My doctor (who is also her doctor) knows us from church and asks about her frequently. I told him some of the things I was noticing and he recommended aricept and nemenda together. I did the samples to ramp up to full dose and she never had an issue. She is normally overly sensitive to any meds.
By the third week she was tremendously better remembering her grand kids names, not stumbling through sentences and actually remembered her past much more clearly including full names! I was stunned.
She still has bad days occasionally when she is out of her own home or during high stress, but overall a dramatic difference in a short time. She also takes zoloft after a big accident a couple of years ago which caused her post tramatic stress that she had trouble getting over. We see no side effects of taking all three meds together.
Zoloft, namenda, aricept.
I am glad there are people here who can understand and be encouraging! Thanks!

My mom started on Ariceptwhen she was first diagnosed. It made a difference - I won't say a huge difference. Then after a year or so when she was getting worse, her doctor added Namenda. Again I saw some improvement.

Now, after more than three years from diagnosis, her doctor has told us to stop the Aricept, that it isn't working anymore. I stopped it and she seemed to get worse so I restarted it (with docs approval)

Then we realized she had a UTI. Now that it's better I'm considering stopping the Aricept again to see what happens. I want her on as few meds as necessary.

My husband was put on Namenda about 2 months after he started Aricept - over 4 years ago - at time of diagnosis. We were assured that there was no reason not to start right away and that it would not be any harm. Since we will never know what our AD loved ones would have been like without drugs, we can only guess BUT we dropped the Namenda for the entry to a drug trial several months after he started and I noticed a difference - less sharpness. It is the drug I encourage people to take - it is suposed to help mental acuity.

quote:

Originally posted by AlzheimerDaughter:
My mother, who has mild-moderate Alzheimer's, has been on Aricept for about a year and a half with some apparent benefit and no side effects. Recently I've seen signs that she's slipping (difficulty signing her name, a little more confusion, repeating herself) and her doctor suggested we try a starter pack of Namenda. Her doctor didn't explain much about the medication. She said to take it instead of the Aricept. I'd like some thoughts about whether Namenda is generally used in addition to or instead of Aricept and what the indications for it are. Have people found it helpful?

Rachele