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 Discontinuing Aricept and Namenda 
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Discontinuing Aricept and Namenda
Robin, I don't think Pat's comment is about starting the medication. It is about discontinuing it when it no longer seems to be effective or is no longer appropriate.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Mon Aug 15, 2011 12:59 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Discontinuing Aricept and Namenda
Yes, thank you, Jeanne. This thread is about discontinuing these drugs and I did refer to keeping patients on them 'year after year'.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Aug 15, 2011 9:48 am
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Discontinuing Aricept and Namenda
I wonder if doctors keep patients on them year after year because they don't know what will happen if they take the patient off--which third the patient will be in--and they don't want to make matters worse.

Julianne


Mon Aug 15, 2011 9:59 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3395
Location: Vermont
Post Re: Discontinuing Aricept and Namenda
Or, are they getting kickbacks from the drug co. like has happened in the past.....

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Aug 15, 2011 12:04 pm
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Joined: Wed Mar 02, 2011 1:11 pm
Posts: 27
Location: Michigan
Post Re: Discontinuing Aricept and Namenda
My husband (fairly advanced LBD) was recently hospitalized for an infection and dehydration. On Friday, his internist told me his heartbeat was too slow, but that it was likely a side effect of the Aricept and that he would D/C it. On Saturday I received a call from a cardiologist saying my husband needed a pacemaker immediately because of his low heartbeat. When I suggested waiting until Monday to see if the Aricept might be the culprit, he told me it couldn't wait. On Monday, when the internist came back, he said, "I see they gave your husband a pacemaker. He really didn't need it. Discontinuing the Aricept would have fixed it." Arrrggg!

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Wife of a 60-year-old LBD patient who was diagnosed in 2003.


Mon Aug 15, 2011 12:07 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3395
Location: Vermont
Post Re: Discontinuing Aricept and Namenda
Just curious as to why a dr. would recommend surgery for someone in the late stages of LBD. Did your husband not have an AD? Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Aug 15, 2011 12:12 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Discontinuing Aricept and Namenda
In most cases, the rationale for keeping a patient on a medication is the same rationale as starting a patient on a medication. Sorry that wasn't clear.


Mon Aug 15, 2011 12:59 pm
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Joined: Wed Mar 02, 2011 1:04 pm
Posts: 251
Post Re: Discontinuing Aricept and Namenda
I think, I respectfully disagree, because I see the point for starting the meds now absolutely......but I hope one day at the late stages, I might be relieved of the side effects of these meds which does include increased awareness of what I can't do which leads to frustration and increased agitation and mood swings, not to mention the GI and stomach side effects I fight daily.......I can totally see a rationale in late stages to be taken off these meds....but I understand situations where that isn't appropriate nor the right time either or not right for every person.....I trust my husband and doctors will know when.......

I think starting and stopping these meds have different rationales....but I have to admit I do not have experience with the late stages.....
Best wishes,

Tonya

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Mon Aug 15, 2011 2:32 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Discontinuing Aricept and Namenda
Debry, the same thing happened to us in AZ. I let them put one in Derek in December 2008 against my better judgment. Derek was in the hospital for another reason and this opportunist was going around looking for candidates. The doctor really bullied me into it and, as his cardiologist at home in WA had just given him a clean bill of cardiac health and none of the staff looking at the monitors ever saw the arrhythmia, it was totally unnecessary. I asked this doctor if he knew that Derek had advanced dementia and he acted like he didn't know what I was talking about, even though it was clearly on his chart. This was in AZ where such practices are not uncommon, according to Derek's neurologist. :-\

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Aug 15, 2011 2:36 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Discontinuing Aricept and Namenda
Pat, my niece the nurse practitioner says of practitioners who push unnecessary or imprudent procedures, "When you're holding a hammer, everything looks like a nail."

But seriously, his conduct was outrageous. How could he justify not taking Derek's advanced dementia into account? It's probably easy pickings for him with a lot of patients because so many patients and families don't question a doctor. I am so sorry that you and Derek had to go through that.

Julianne


Mon Aug 15, 2011 3:54 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Discontinuing Aricept and Namenda
Debry,
That's quite a story. You might like to know how to have a pacemaker stopped. There was a good article in the NYT awhile back on this topic:
http://www.nytimes.com/2010/06/20/magaz ... ker-t.html
Robin


Mon Aug 15, 2011 3:55 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Discontinuing Aricept and Namenda
Excellent article, Robin. Thank you for sharing it. If nothing else, it exposes the kinds of pressure we are under when we know NOT to consent to life-extending measures but are coerced into them, anyway.

Julianne, your niece has it down exactly!

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Aug 15, 2011 5:36 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3395
Location: Vermont
Post Re: Discontinuing Aricept and Namenda
Great article. Death with dignity is my philosophy too! Both my GP and cardiologist are well aware of my views and my lengthy AD, as are my husband, children and friends. It is so important to make our wishes known to those who may have to make decisionis (or not) in the future for us. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Aug 15, 2011 7:55 pm
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Joined: Wed Mar 02, 2011 1:04 pm
Posts: 251
Post Re: Discontinuing Aricept and Namenda
Lynn,

You have "lengthy AD" as in Alzheimer's for a long time now? or did I misunderstand? Are you on meds?

Best wishes,

Tonya

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Mon Aug 15, 2011 8:07 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Discontinuing Aricept and Namenda
I believe by AD she meant 'Advanced Directive'.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Aug 15, 2011 8:55 pm
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