Alzheimer's Disease: Should I Take Medicines?

Alzheimer's disease damages the brain. It causes a steady loss of memory and affects how well you can speak, think, and do your daily activities.

Alzheimer's disease gets worse over time, but how quickly this happens varies. Some people lose their ability to do daily activities early on. Others may do fairly well until much later in the disease. As the disease gets worse, you may:

• Have trouble making decisions.
• Be confused about what time and day it is.
• Get lost in places you know well.
• Have trouble learning and remembering new information.
• Have trouble finding the right words to say what you want to say.
• Have more trouble doing daily tasks like cooking a meal or paying bills.

Medicines can't cure Alzheimer's disease. But they can slow down the way it affects your brain and make the disease easier to live with.

• Cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) are the most commonly used medicines for Alzheimer's. They can boost memory and the ability to do daily activities. They can be used in all stages of the disease.
• Memantine (Namenda) can relieve symptoms of memory loss, confusion, and thinking problems. It may help you in the middle and late stages of the disease, when your symptoms are severe. You may take this medicine alone or with cholinesterase inhibitors.

Other medicines may be used to help with anxiety, agitation, anger, or other symptoms like these.

Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember. Over time, as your disease gets worse, medicines will stop working. The long-term effects of these medicines are not known.

Most people are able to take these medicines without problems. Most side effects go away within a few weeks after you start taking the medicines.

The most common side effects of cholinesterase inhibitors are:

• Nausea (feeling sick to your stomach).
• Diarrhea.
• Vomiting.
• Upset stomach (indigestion).
• Lack of hunger.
• Weight loss.

Other problems are less common. You may feel very tired, have trouble sleeping, or have muscle cramps.

Common side effects of memantine are:

• Dizziness.
• Confusion.
• Headache.
• Trouble moving your bowels (constipation).

It's important to have regular visits with your doctor while you are taking these medicines. As the disease gets worse and symptoms change, your medicines or doses may change too.

If you are caring for someone who has Alzheimer's disease, watch for problems or side effects from medicines.

If you have been diagnosed with Alzheimer's disease, you may feel angry, frightened, depressed, and worried about the future. Even though the disease gets worse over time, some people are able to keep up their daily activities for many years, even if they do them at a reduced level or in different ways.

Try some of these ways to cope, with or without medicines:

• Scale back on activities to match your abilities. A task may take longer than it used to, but if you want to keep doing it, you should try. Make changes as needed. For example, if you no longer feel comfortable cooking, think about other things you can do, such as shopping and meal planning or setting the table. Or try using simpler recipes.
• Schedule activities and tasks for the times of day when you're best able to handle them. It may help to have a routine that doesn't change much from day to day.
• You or your caregiver can help avoid confusion at home by labeling often-used rooms and objects.
• Before you go out alone, write down where you are going, how to get there, and how to get back home. Do this even if it's a place you have gone many times before. Take someone else along when you can.

Talking with people who know about Alzheimer's can help by teaching you about the disease and how to cope. Contact Alzheimer's organizations, look for community services, and attend support groups to learn as much as you can.

Your doctor may recommend that you take medicines for Alzheimer's if:

• Medicines will make it easier for you to do daily activities.
• Medicines will reduce your symptoms and make it easier for others to take care of you.