So why take medication for dementia if there is no cure? What is the medication going to do? What are the side effects? Are they expensive?
These are just a few of the questions that I have been asked by my patients and their caregivers. So first let me restate that at this time there is no cure OR prevention for dementia.
So why take medication? Because what we know is that taking the medication such as Aricept/donepezil and Namenda/memantine slow down memory loss by approximately 18-24 months.
Although that may not seem like a long period of time it is better than no delay in progress at all. It is 1-2 more holidays, birthdays and opportunities for creating memories to for a family to cherish for a lifetime.
It also allows for time to make decisions and preparations. Beyond verbal recall, it also helps to preserve muscle memory. This is so important for a few reasons. First it allows the person with dementia to remain active longer, to ambulate and to participate in physical activities. We know that movement is good for overall physical and mental wellness as well as a good way of keeping a person’s mood stable and helping to reduce the risk of depression. Secondly, this helps promote good lung expansion which is vital in terms or reducing the risk of pneumonia and other respiratory associated illnesses.
Lack of movement increases the risk of becoming sick and is associated with a weaker immune system.
So how do these medications work? Well although they are not completely understood, what is known is that the cholinesterase inhibitors (one of 2 categories of memory medications) helps delay the destruction of acetylcholine. Acetylcholine is a neurotransmitter (chemical) that plays a vital role in communication. In dementia, acetylcholine is broken down quicker than it should be preventing memories from being embedded into the brain and also hastens memory loss.
The medications that are cholinesterase inhibitors allow acetylcholine to last longer than they would without the medication. The other category of medication called NMDA receptor antagonist helps to reduce the amount of glutamate released by destroyed neurons. Glutamate is a neurotransmitter that has an excitatory quality. Too much glutamate can cause confusion and agitation.
The only drug in this category is called Namenda/memantine.With respect to side effects – Well although these medications are typically well tolerated, there are some possible side effects that you should be aware of. With the cholinesterase inhibitor class, you could have GI upset, headaches or possibly vivid dreams. Most people who take these medications tolerate them without complaint. The NMDA receptor antagonist (Namenda) can cause diarrhea/constipation, headaches, insomnia and even depression.
Just like the cholinesterase inhibitor class, most people do not have any side effects and if they do, they tend to be mild and only last until they get used to the medication.Both of these medication classes take 2-4 weeks to become therapeutic so it’s important to not rush to judgement on whether or not they are beneficial. As always, if you are having any problems or concerns with these (or any) medications you should talk with the prescribing provider.Finally, about cost – Well the good news is that all medications for memory are now available in both branded and generic form. Although some may be more expensive than others, insurance does tend to cover these with very rare denials.I hope this answers a lot of your questions and concerns about memory medications. If you have any questions about this blog entry or any other questions, you can always write to me at:
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