New diagnosis donepezil yes or no

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I'm really praying for some good advice here. I have had concerns for some time with regard to my husbands memory. He has recently had scans and two psy assessments and we have now been told he has they feel mixed dementia, this is because the scan showed some mild ischemic changes. As its mixed, they are offering to medicate him with donepezil, as they are saying this is in the early stages - I'm not so surem but he did score well on many of the assessments. My husband is 71 and I'm so frightened, I just think he's going to die, this awful death and there's not much I can do. I'm always guarded about medication because of side effects, though the memory clinic clearly think he should try it. He is also a tablet controlled (badly) diabetic. His sister has been on donepezil for two years and she still seems to have declined. I just don't know what to think. I'm looking hard at his diet. Am I going to lose my husband soon?

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  • Posted

    Dear Georgina, So sorry to hear about this. My mother suffered from vascular dementia for nine years before her death, and now a dear friend has it too.

    Although I'm a former nurse, I don't know much about donepezil (aka Aricept) first-hand, as I'm now 70 myself. I do, however, know that it can be very effective in slowing the progress of Alzheimer's. My friend's neurologist tried her on the drug, even though an MRI scan and the neuro-psychological test proved she doesn't have Alzheimer's. It's believed in the continental European country where we live that it can bring about behavioural improvement where this is a problem, even in the absence of Alzheimer's. In the event, it made no difference to her severe behavioural problems and was discontinued after six months. In my friend's case, persistent diarrhoea was the main reason for stopping the drug. However, it has to be said that she's suffered from IBS (and possibly coeliac disease) all her life, so it was unsurprising that this known side-effect would cause a particular problem for her.

    It sounds to me as if it would be well worth giving it a try in your husband's case. It's not one of those drugs that causes worse problems when withdrawn (unlike the powerful anti-psychotics my poor friend was given) so you've nothing to lose if the doctors decide to stop it after a while. As far as I'm aware, there are no particular risk factors for diabetics, though you should, of course, make sure that the doctor at the memory clinic has the full list of other meds he's taking.

    And putting him on a diet rich in vegetables and fish (including oily fish one a week) wouldn't do any harm at all. Gingko biloba has also been proven to improve memory in some medical trials. I tried my mother on it but it didn't seem to make any difference, though this was possibly because she didn't take it every day.

    Finally, try and stay optimistic. After all, we none of us know the hour of our death. Both Alzheimer's and vascular dementia progress at different speeds in different patients, so it's impossible to make predictions. The damage caused to the individual's personality is also unpredictable. Many dementia sufferers - whatever the cause - remain placid and happy till the end. My mother lived on for nine years after her dementia started becoming obvious, and my friend is now about seven years down the road, and still in good physical shape.

    All the best, Lily

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    • Posted

      Thank you for taking the time to reply. I'm just so worried that he'll take something that may make him worse. We had this woth an anti depressant (Mertazpine, think I've spelt that wrong) but I'm convicned it caused changes that we didn't come back from and I don't want a repeat Georgina
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    • Posted

      My friend takes mirtazepine too, but it seems to help a bit. She has a history of reacting badly (and permanently) when benzos or anti-psychotics are withdrawn but I honestly can't say donepezil changed anything either way, apart from the diarrhoea. That's why I suggested giving it a try. But of course, it's not a miracle cure and will only slow down the progress of the disease, if it works at all. Bear in mind too that vascular dementia (which I'm assuming is in the "mix" you describe) typically causes sudden deteriorations, as opposed to the long, steady decline of Alzheimer's, so the change wasn't necessarily down to the drugs.

      The drugs you should really worry about are the neuroleptic (anti-psychotic) group. These aren't supposed to be prescribed for dementia but they regularly are. Risperidone (trade name Risperdal) is the worst, in my opinion, and also the most likely to be prescribed for dementia sufferers. Avoid this one like the plague, if you can. Others are clozapine (trade name Leponex) and olanzapine. I'm not in the UK, so you may find different trade names there. If your husband's doctor prescribes something without telling you what it is, look at the notice inside the packet or ask the pharmacist for the chemical name and group it belongs to, so you can google it.

      At least your husband is fortunate to have you as his advocate.

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