The Exelon should improve thinking in general - the thing is, the effects of Exelon monotherapy can be pretty subtle - it's more a question of keeping things from getting worse, and being a little more "involved" than without it.
The delusions and agitation are sometimes improved by drugs like Exelon, but usually it requires a second class of drug. There is substantial debate as to the "best" option for that second drug.
In North America, most DLB patients with these symptoms are treated with low doses of what are called "atypical antipsychotics". There are a variety of them on the market - they're more alike than different in efficacy and safety. . . they tend to work, at the risk of sedation and weight gain/diabetes, the latter in higher doses.
The second option (and it's really not either-or, some people use both, like our LO with DLB, Cal) is a class of drugs called psychostimulants. The hypothesis is that these delusions are caused by intrusions of dreaming into the wakeful state - keep the patient a little more awake, things get better. One of the leading experts in DLB treatment uses this class extensively with his patients.
The delusions make caregivers crazy - in our case, they were quite resistant to the antipsychotics, and they got progressively more problematic in the months before the diagnosis. I'd encourage you to search here for "modafinil" or "Provigil" or "psychostimulants" using the search button at the top of each page for more about how much of a fan we've become of these agents in our LO.
On the LBDA site, there's a great paper,
http://www.lewybodydementia.org/docs/DL ... nuum04.pdf
- it illustrates a number of great management strategies for DLB - if you find a clinician experienced in such comprehensive management, you'll have a very different experience with this disease than if you don't.
None of this is acutely fatal - it's all just crazymaking for family members and other loved ones, so there's time to find what works. A good thing to keep in mind is that DLB brains are very sensitive to some medications, so it's generally a good idea to start with the smallest possible dose and make dose changes slower than one normally would.
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