Cholinesterase inhibitors (e.g. Aricept)

saranita

My mother has mild to moderate dementia. Her memory and confusion are variable, sometimes even regardless of time of day. I do not know if she remembers being diagnosed with MCI, but she does not know she has been diagnosed with dementia. In December 2020, her doctor finally convinced her to try Aricept, just saying it would help her memory. She took it once and later that day or evening got a migraine, so she assumed the Aricept caused it and refused to take it again. Her migraines ate triggered by various things so I am not sure Aricept caused that one. She forgot about all this so when we with her doctor last wee, he mentioned Aricept again & she agreed to consider trying it again IF she can read an article about a study showing evidence of its effectiveness. She was a university med school professor and cell biologist, and still has some medical knowledge. I was thinking I would find one and read it to her (it is very difficult for her to read due to macular degeneration). That way I can leave out the word dementia. However I couldn’t find anything that showed evidence of significant benefits, and a friend of mine said her mother tried it for a few weeks but it made her feel terrible (not sure how) and so she stopped taking it herself.  Is it worth my trying to convince my mother just to try it again?

dayn2nite2

In my experience, Aricept, Namenda and Exelon were all a gigantic waste of money.

star26

My Dad tried Aricept and Razadyne at different times but quit both after no more than a couple weeks due to side effects: loss of appetite, irritability and bad mood, and feeling "just not right" from what I recall. My sense from reading a lot of reports about it here is that if someone is one of the few to benefit, the benefits will be modest, before they eventually wear off. To me, it seems like there's more people that say they're not sure if it's working or not but they keep taking it just in case. This is why I didn't feel it was worth having my Dad soldier through the side effects or trying any of the other similar meds. Your Mom might have the right viewpoint on it. Maybe give her the facts and let her decide if she wants to risk a possible migraine to see if she could be one of the few that notices some temporary improvement?

Quilting brings calm

See if she will try the rivastegmine patch( generic Exelon).  My Mom has been on that for about 18 months.  Doesn’t seem to be adversely affecting her.  It’s hard to tell if she is benefiting because this disease is so different in duration for everyone.

M1

Anecdotal experience from thirty years medical practice: I never personally saw anyone benefit. The studies will say there is slight benefit. Up to Date, which is a good online resource, says one in twelve will benefit, one in twelve will have a significant side effect, and the other ten it will make no difference.

saranita

Thanks so much to all of you!

Michael Ellenbogen

It has been a life saver for me and many of my friends with dementia.

Crabcakes

I agree. I see no difference with Aricept, and they have since added Namenda. The docs at the memory clinic still encourage him to take it, saying if he stops, we would see how it really is working! I am going to stop the Aricept because of his diarrhea.

Gig Harbor

My husband started Aricept in Jan 2016. He had started having hallucinations that involved hearing people talking outside our window at night. These stopped and never occurred again. Recently I forgot to fill his pillbox with them. Within three days he became confused every afternoon and fixated on various things. I restarted it and the confusion stopped. I can only say that for him it helps his quality of life and mine as well. It does not stop the progression of the disease but it helps him function better while the brain destruction is happening. At some point it will no longer help but for now it is worth the cost.

Gig Harbor

He takes Aricept with breakfast and it eliminated the GI symptoms vs taking it at night. He also takes memantine twice a day.

PanamaFarmer

My mother's doctor has also recommended her to take Aricept or Donepezil as it is known here in Panama. Before we do, I wanted to research and see if anyone knew of any herbal alternatives for a cholinesterase inhibitor? I have learned of Calamus (acorus calamus) but still researching it. I am a big believer in natural remedies & healthy lifestyle first before pharmaceutical drugs but I understand they could be complementary. Thanks.

Lane Simonian

  Panax ginseng/Korean Red ginseng is one of the best herbal treatments for dementia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190533/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223013/

Many studies focus on particular ginseng constituents, but many compounds in ginseng are neuroprotective and neuro-restorative. 

The following study compared conventional therapy (mostly Aricept and Namenda) alone with conventional therapy combined with Chinese herbs (including panax ginseng).  It would have been interesting to see if the herbs produced the same effects without conventional medicines.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729264/

Essential oils via direct inhalation aromatherapy can also help with Alzheimer's disease and vascular dementia (some of the more stimulating ones such as clove may increase anxiety in some people; rosemary, bay laurel, lemon balm, lavender, and sweet orange are usually good alternatives in these cases).

https://scienceline.org/2011/03/lavender-and-old-lace/ (including comments by Julie Diehl).