Maybe it happened
when your wife got lost driving to the neighborhood market. Or when your father
received a cut-off notice because a utility bill was not paid for two months. Up
to that point you thought the forgetting was “normal aging”—a series of
“senior moments”; now you can no longer deny that someone you love has
started to have serious problems with daily tasks.
Next comes the
doctor’s appointment…a discussion of recent problems with memory, judgment
and functioning…some medical tests; then, the terrible moment when the doctor
informs you that your loved one is showing signs of dementia.
What is dementia? It
is the loss of thinking abilities that were mastered early in childhood. These
abilities include memory, the ability to perform multi-step tasks, the use of
language as well as higher order functions like judgment, planning and
organizing. There are a number of diseases that can cause this impairment. The
most common causes include Alzheimer’s disease, multi-infarct dementia and
diffuse Lewy body disease. Each of these illnesses shows a different pattern of
symptoms and progression.
While most forms of
dementia can’t be cured, there are now treatments that can make a significant
difference in the course of the illness. A group of medications called "acetylcholinesterase
inhibitors" works by boosting the strength of signals that are sent by
nerves within the brain using the chemical messenger, acetylcholine. It is
surprising that while these medications were developed for treatment of
Alzheimer’s disease, there are growing reports that they help other forms of
dementia as well.
The three most
commonly used medications, donepezil (Aricept®), rivastigmine (Exelon®) and
galantamine (Reminyl®) don’t change the course of the illness. However in
adequate doses they restore cognitive functioning to where it was about 9 months
previously. While that may not seem like much, consider for example the person
who has just started to have trouble caring for himself. With such medication,
they might enjoy 6-12 more months of independent living.
aren’t generally dangerous. Nausea and diarrhea are common side effects.
Because of this, small starting doses are generally increased gradually as
For some patients
these medications can restore the ability to recognize family members, to
socialize or to care for themselves, at a point where these abilities were
faltering. Even a modest difference can mean a lot.
consult your health care provider before taking medication. We do not specifically endorse any particular medication.
Articles about Psychiatric Medication