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Neurology (Expert Forum)
Alzheimers disease treatment.
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Alzheimers disease treatment.
by Christie2004, Mar 15, 2005 12:00AM
My Dad was dx w/Alzheimers about a year ago, and rec'd no medical treatment for it(was pretty "with it") until about 3 months ago when he was enrolled in a clinical trial involving patches in Columbus, OH.
The problem is this: my mother was his primary caregiver until her decline 3 weeks ago and she died this past Monday. My fathers condition began RAPIDLY deteriorating when she fell ill, and now needs pretty much 24/7 care (he wanders). The people involved with the clinical trial are discouraging us from dropping out of the study, saying "conventional" treatment "won't help anyway" and that we should just continue on.
My take is that the study drug is not helping AT ALL, and due to the rapid decline we are noticing, I believe he needs to be on something else. I don't have a HCPOA, and my sister (who does) believes the study people.
What is the current standard of care treatment for Alzheimers? He needs assist w/most ADL, sundowns TERRIBLY, yet is relatively ok so far as confusion during the day. He occasionally hallucinates. He has declined so rapidly I see dramatic changes when I travel to see him weekly. He is being placed in a more appropriate facility next week.
If this were YOUR father, what would YOU do?
The problem is this: my mother was his primary caregiver until her decline 3 weeks ago and she died this past Monday. My fathers condition began RAPIDLY deteriorating when she fell ill, and now needs pretty much 24/7 care (he wanders). The people involved with the clinical trial are discouraging us from dropping out of the study, saying "conventional" treatment "won't help anyway" and that we should just continue on.
My take is that the study drug is not helping AT ALL, and due to the rapid decline we are noticing, I believe he needs to be on something else. I don't have a HCPOA, and my sister (who does) believes the study people.
What is the current standard of care treatment for Alzheimers? He needs assist w/most ADL, sundowns TERRIBLY, yet is relatively ok so far as confusion during the day. He occasionally hallucinates. He has declined so rapidly I see dramatic changes when I travel to see him weekly. He is being placed in a more appropriate facility next week.
If this were YOUR father, what would YOU do?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Mar 16, 2005 12:00AM
Alzheimer's disease is a chronic degenerative disease with no known cure
Despite intensive research the exact cause is still not clear, but new treatments to slow the course of the disease may be on the horizon
Today, there a 2 types of medications that have been shown to slow the clinical course of Alzheimer's. No medication has been shown to stop or reverse the disease process
The acetylcholinsterase inhibitors such as Donepazil, Galantamine and Rivastigmine can slow the cognitive symptoms in many patients(such as memory etc) but only by several months. Although most studies did not look at the effect on caregivers, a study with Rivastigmine showed a significant benefit to caregiver stress and ability to cope. These drugs are now fairly standard of care for Alzheimers dementia.
Another drug recently approved for more moderate to severe Alzheimer is Memantine, which works in a different way to the above drugs but has also been shown to slow the clinical course of the disease. All these drugs are approved by the FDA for Alzheimers(Federal Drugs Administration).
Hallucinations and rapid fluctuations are a feature of Lewy Body dementia - I am not sure if this is a diagnostic consideration in your father without seeing him myself. It is similar in ways to Alzheimers and the same treatments above are effective also
Clinical trials are essential to our advancement in treatment of diseases like Alzhemiers, and this is how the above drugs were shown to be effective. I do not know the details of the trial, but you should discuss your concerns with his doctors, and whether any of the above drugs might be indicated. The benefit from these drugs is limited - that is why we are still looking for more effective treatments.
Despite intensive research the exact cause is still not clear, but new treatments to slow the course of the disease may be on the horizon
Today, there a 2 types of medications that have been shown to slow the clinical course of Alzheimer's. No medication has been shown to stop or reverse the disease process
The acetylcholinsterase inhibitors such as Donepazil, Galantamine and Rivastigmine can slow the cognitive symptoms in many patients(such as memory etc) but only by several months. Although most studies did not look at the effect on caregivers, a study with Rivastigmine showed a significant benefit to caregiver stress and ability to cope. These drugs are now fairly standard of care for Alzheimers dementia.
Another drug recently approved for more moderate to severe Alzheimer is Memantine, which works in a different way to the above drugs but has also been shown to slow the clinical course of the disease. All these drugs are approved by the FDA for Alzheimers(Federal Drugs Administration).
Hallucinations and rapid fluctuations are a feature of Lewy Body dementia - I am not sure if this is a diagnostic consideration in your father without seeing him myself. It is similar in ways to Alzheimers and the same treatments above are effective also
Clinical trials are essential to our advancement in treatment of diseases like Alzhemiers, and this is how the above drugs were shown to be effective. I do not know the details of the trial, but you should discuss your concerns with his doctors, and whether any of the above drugs might be indicated. The benefit from these drugs is limited - that is why we are still looking for more effective treatments.
Thanks again.