So done with Donepezil

CatsWithHandsAreTrouble

Sorry for another poop topic but I just need some suggestions and maybe a pep talk.

Mom has been on 5mg donepezil (generic name) since maybe May, possibly April. A little after she started taking it, she started having diarrhea and not making it to the bathroom in time with other loose BM. At the time, she was also eating a lot of candy and sugar-free mints without supervision and I thought that was from that. We increased her fiber intake, hid the candy, and stepped up on taking her to the bathroom in a timely order. We still had a few accidents but things were seemingly getting manageable. 

In June my older sister (os), the one who does mom's medical business, mentioned that a side effect of donepezil was diarrhea but she didn't think it would be a problem because mom had been constipated once in late March. I was floored. This whole time I thought it was mom's diet but it could have been a pill. I didn't even know why she was put on donepezil, just came home with the prescription from OS.

Mom's also on setraline and one of her doctors (wasn't told which) told us to reduce her prescription, because apparently that also has diarrhea as a side effect. We tried that. It didn't seem to make a difference except that mom was more anxious than usual so we went back to the previous amount for the setraline. It's been one week since we went back.

I'd like to stop the donepezil since the trouble started when she went on it. Although, the donepezil seemed to help mom, was a lot more "with it" and could do ADLs better, so I'm hesitant on if we should stop the donepezil or not.

Mom's also on memantine, and that also has diarrhea from what I've seen while looking through past topics on here. I told OS about it and suggested bringing it up with the doctor to try reducing that. I didn't hear back from her on it, left the message on read.

This early morning mom couldn't get to the bathroom and pooped herself in her pajamas and my dad seemingly left her there soiled. Thankfully I was right there and got her cleaned up. He seemingly had no clue what happened to her when he got back into the room. 

I don't think she's even urine incontinent so it's really frustrating that she keeps pooping herself. She's always so heart broken when it happens. I don't exactly mind her pooping herself so long as it's in the bathroom and she is wearing dark clothes! but this is no way to live. Especially since it's getting difficult getting fluids in her, we don't need it lost to diarrhea.

Any suggestions or sympathy would be great. At least when she truly becomes fecal incontinent, we're already somewhat used to it. The silver lining

mommyandme (m&m)

Bowel incontinence alone is difficult, but diarrhea incontinence…You have my sympathy.  Very sorry for this complication.  I’m not a doctor but what about using more binding foods like bananas and cheese to help counteract the possible med side effects?  The BRAT diet might help if her stomach is upset and may reduce stool production.  I’ve read high fiber foods may not be the best idea for diarrhea as it promotes stool.  Again, not a doctor.  

Hope she gets some relief soon.  

CatsWithHandsAreTrouble

Thanks m&m! The higher fiber seems to help keep the diarrhea at bay but over the weekend the diet gets a little slack and we have the most trouble on Mondays or mornings when she hadn't a bowel movement before bed. She gets about 20-36g of fiber a day if I can help it. Recommended amount I've seen has been roughly 31.

I'm hesitant on cheese though and have given the BRAT diet a couple of thoughts. One weekend she had very explosive diarrhea and we somewhat did the diet for her and it resolved by Wednesday that week. Not sure how applicable it would be to continue eating that way. Mom won't eat food if she perceives a difference between ours and hers so we'll all have to go on it.

I did buy some bananas for her the other day! I got it for the potassium and how it's fairly filling. We also give her apples, which is said to help with diarrhea, but I'm not sure if that works or not because she won't eat the skins. Either way, it's nutrition and extra way to get fluids into her so it's no big deal in that sole regard.

I would so love to talk to her doctor on it but my sister hasn't seem to be communicating beyond the initial setraline talk. I don't know which doctor it was either so I can't give her the information on mom myself.

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GothicGremlin

Hey there- my sister is on both of those medications, and has been almost since her diagnosis. She's also had the same symptoms as your mom.  Like others, I'm not a doctor either, but bananas were also recommended to Peggy. She usually has half of a banana in the morning and a half at night (right around the time she takes her medications).  It has seemed to help.  Of course, now that she's in late stage 6, nothing helps with the incontinence, but prior to that, bananas worked like a charm.  I can't speak to any of the other foods, and Peggy is lactose intolerant, so no cheese for her, or any other kind of dairy.

Peggy recently started taking sertraline (maybe 5 months ago?), but she was already incontinent when she started it, so I'm not sure if part of the incontinence is from the prescription, or if it's just the progression of the disease.

I talked to Peggy's doctor about quitting the donepezil and the memantine, but she strongly recommended against that, so Peggy remains on those drugs.

So.... that's my experience with those drugs. I'm sure it's like all Alzheimer's stuff - everyone is different. But hopefully it's a little bit useful.

Iris L.

Consider Exelon patches, generic name rivastigmine, as an alternative to donepezil.  

Iris

60 falcon

I stopped giving donepezil because of diarrhea.  That was a few years ago.  Just recently her doc made some other med changes and he recommended adding Exelon patches also. My wife has been using those for about a week now with no side effects.

CatsWithHandsAreTrouble

Thank you all for the suggestions! I'll make a list for my OS so she can bring it up with the doctor. My mom has both a primary care family doctor and a neurologist that specializes in geriatrics. Should both be informed by this issue? I don't do doctor stuff so I'm a fish out of water here.

mommyandme (m&m)

Victoria2020, 

Thank you for posting the diet resource! 

CPLinIN

https://alzconnected.org/discussion/61755/so-done-with-donepezil

This is happening with my husband when I am at work. We've been operating with him being home alone, but I fear this issue alone will force me to retire to better care for him.

He's been taking 10mg of Donepezil for about a year with only a few incidents, but they're increasing. I'm also coming home to find that he has been grazing in the kitchen all day - it is probably time to consider locking a few cabinets.

M1

Welcome to the forum CPL. You have posted on an old thread and will probably get more responses if you start a new discussion (no worries, this happens a lot as folks get used to the site).

YYou should probably talk to his docs about stopping the Aricept to see if it makes a difference. But your other concern is more pressing. He's probably not safe to be home alone. I'm sorry, ad that obviously has huge implications. Is day care a possibility?

ButterflyWings

I agree with M1 on both points: start your own “New Discussion” for best responses. And your LO needs to be supervised, like yesterday. If you have not yet safety proofed by removing meds, chemicals, oven knobs, etc- consider yourselves really lucky but don’t chance it even 1 more day.

My DH ate enough of a non-toxic non-food substance recently (sitting in the backseat of the car while I drove us without suspecting a thing!). It caused a day of upchucking and overnight diarrhea, and we were REALLY lucky. Do take action now. Our PWD LOs need someone to make sure they don’t harm themselves. And it only takes a moment for things to go really wrong.