Alzheimer's Disease: Should I Take Medicines?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Alzheimer's Disease: Should I Take Medicines?
Get the facts
- Treat Alzheimer's disease with medicines for as long as they are helpful.
- Don't take medicines. Try other ways to improve thinking and memory and to reduce confusion.
Key points to remember
- Medicines can't cure Alzheimer's disease, but they can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.
- Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.
- Medicines may cost a lot. You can try taking them for a while to see if they help and if that help is worth the cost to you.
- These medicines have side effects, but many people are able to take them without problems. Side effects can include nausea, diarrhea, vomiting, belly pain, weight loss, and lack of hunger.
- Some people with Alzheimer's disease are able to keep up their daily activities for many years, even if they do them at a reduced level or in different ways. If you decide not to take medicine, you can help yourself by scaling back on activities to match your abilities. You can also try scheduling activities during the times of day when you can best handle them.
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 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).
- 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:
- 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.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You take pills every day for as long as they help your symptoms.
- You see your doctor regularly to check how well the medicines are working. As the disease gets worse, you may want to try a different medicine, dose, or combination of medicines.
- Your memory and ability to think clearly may get better for a short time.
- Medicines may slow down the effects of the disease. You may be able to stay independent longer.
- Medicines may not help everyone who has Alzheimer's disease.
- Medicines can't cure the disease. Over time, medicines will stop working.
- Medicines can cost a lot.
- Side effects include:
- Upset stomach.
- Lack of hunger.
- Weight loss.
- You or your caregiver can try other ways to reduce confusion, such as labeling often-used rooms and objects.
- You can try other ways to cope with the disease, such as scaling back on tasks to match your abilities.
- You avoid the cost and side effects of medicines.
- If you are not able to cope on your own, you can try medicines later.
- You may not be able to cope with your symptoms without medicines.
Personal stories about taking medicines for Alzheimer's disease
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
As long as I'm doing all right, I would like to stay off of medicines. Some days it's really hard, because I get confused and even frightened. But I don't tolerate medicines that upset my stomach very well, and I'd like to stay feeling as well as I can until my disease progresses. My wife knows to put me on medicines if I become violent or if my behaviors become burdensome to her.
Jed, age 62
I was just diagnosed as being in the early stages of Alzheimer's disease. I'd like to remain as mentally clear as I possibly can for as long as I can. I'm going to try taking a cholinesterase inhibitor called Aricept, because it may help delay the this condition for a few more months. Even though that's not a long time, every day is precious to me.
MaryAnne, age 74
My wife, Sally, left instructions that she would like to be put on medicines if her personality changes and memory loss become a burden for me. Her memory loss and thinking problems have become severe, so her doctor has prescribed a new type of medicine called memantine that might reduce these symptoms. Even though no medicine will prevent the disease from progressing, I want to keep my Sally with me for as long as I can.
Joel, age 81
Fred, who is 77, is in the later stages of Alzheimer's disease. He was taking cholinesterase inhibitors and then memantine for several years with good results. But his body is no longer responding to the medicines. He is incontinent, and the medicines give him diarrhea. My sons and I have decided it's time to take Fred off the medicines and let the disease run its course.
Harrietta, age 73
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicines to treat Alzheimer's disease
Reasons not to take medicines
I want to keep doing my daily activities as long as I can, even if it means taking medicines.
I want to keep doing my daily activities without relying on medicines.
I think taking medicines will help me stay independent longer.
I don't think taking medicines will make a difference in how independent I am.
The cost of the medicines doesn't bother me.
I'm worried about the cost of the medicines.
I can deal with the side effects of these medicines.
I'm worried about the side effects.
Even though medicines may not work for me, I still want to try them.
I don't want to try medicines if they aren't going to work.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT taking medicines
What else do you need to make your decision?
Check the facts
Do medicines make a big difference for everyone with Alzheimer's disease who takes them?
- YesSorry, that's not right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.
- NoYou're right. Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.
- I'm not sureIt may help to go back and read "Get the Facts." Medicines may not work for everyone. Even if they do work, they may not make a big difference in how you think and remember.
Can medicines cure Alzheimer's disease?
- YesNo, that's not right. There is no cure for Alzheimer's disease. But medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.
- NoYou're right. There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with. They may relieve symptoms such as having trouble thinking and remembering things.
- I'm not sureIt may help to go back and read "Get the Facts." There is no cure for Alzheimer's disease, but medicines can slow it down for a while and make it easier to live with.
Do most people who take medicines have problems with side effects?
- YesSorry, that's not right. These medicines have side effects, but most people are able to take them without problems.
- NoYou're right. These medicines have side effects, but most people are able to take them without problems.
- I'm not sureIt may help to go back and read "Get the Facts." These medicines have side effects, but most people are able to take them without problems.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Myron F. Weiner, MD - Psychiatry, Neurology|