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Post by Bobute on Oct 13, 2005 18:18:01 GMT -5
Hello again. Pat has suggested I ask you about some current problems I seem to be having. She, as many others, know you will find the answers we so much need.
I was put on Namenda at the same time Katrine came through. I began on 5mgs, have not increased the dosage.
As expected my set patterns were upset with being displaced from our home for two weeks, plus the damage we faced upon returning.
I feel my writing is on a roll, but I am having problems finding the keys to spell correctly, some nightmares, and an uneasy restlessness which Pat has noticed.
I was diagnoised first with atrophy and dementia after a mini stroke and Ramsey Hunt which paralized the right side of my face. I had shingles in my right ear a year after the mini stroke.
6 months or so later, after an MRI with contrast I began being more forgetful, angry, impatient and depressed.
Then I was sent to a nuro who tested mE and said I was in the begining stages of Alz. Airicept was recommend, which caused serious nightmares. I could not take it, so I have been on Exelon since.
My other doctor recommended Namanda, the neuro agreed, so now I am confused about the changes that are aggravating mE greatly.
I understand Namanda is later stage medication. Could this possibly be the cause along with the stress and upsets of my recent problems?
Thank God for Pat. She has learned so much from you and with her mother going through this. I trust her and you for advice. She can tell when changes occur sometimes before I do.
Thank you for your compassion and time.
God bless
Bobute, mE
xoxox
PS, I did have a second MRI ordered by the Neuo before she tested mE in her office.
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Post by snowylynne on Oct 13, 2005 18:45:04 GMT -5
Didn't the Dr.give you a Tritation Pack to start with Barbara?They do as a rule............
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Post by snowylynne on Oct 14, 2005 9:01:32 GMT -5
More Neurologists are giving Namenda earlier to keep the person more normal.Later in the disease It may not work as well as it will now.Keep taking the Namenda Barbara..........
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Post by norbert1 on Oct 14, 2005 9:43:40 GMT -5
Dear Bobute,
I will do the best I can.
First lets talk about Aricept. I it has been around longer and I understand its function better. Aricept is slightly activating. It is also known to cause vivid dreams. The package insert says to take it at night because that was the way it was given in the tests used for FDA approval. It was given in the evening because it was felt that patients would be less bothered by the Gastro Intestinal effects while sleeping. When vivid dreams are a problem, some doctors will instruct the patient to take the aricept in the morning instead. (There is now increased agreement that aricept is helpful for people with vascular dementia, primarily because there is often Alzheimer disease process that seems to occur along with the vascular damage, and even a low level of alzheimers disease process has a greater effect when there is already vascular damage.
The second issue is namenda. It is approved for moderate to severe alzheimers. Some doctors have operated under the philosophy that if they could not give aricept, then they would try namenda so that the patient is at least getting something (even in mild stages). But - they have run a series of tests using namenda for people with mild to moderate alzheimers, and the benefits were not significant. I am not sure if they even tried to get approval for this group (mild to moderate). If they did, it was denied because of lack of benefit.
One effect of namenda is it can be quite activating. Some have posted about it causing violent rages in their LO’s. (I personally believe that this seems to have occurred when the person’s dementia was not Alzheimers, but some other type of dementia.) I have not heard of namenda being beneficial for any type of dementia other than alzheimers in the moderate to severe stage. The way namenda works gives no indication it would be helpful in other types of dementia.
By the way, the dosage for Namenda is a scheduled buildup starting at 5mg/day, with weekly increases. Week 2, 5mg 2x/day. Week 3, a 5mg and a 10mg dose each day. Week 4 and beyond, 10mg 2x/day.
So my understanding of your situation… Your disability is primarily the result of a single stroke event? Is there any indication of continued progressive vascular damage of the type associated with vascular dementia (Multiple Infarct Dementia or Transient Ischemic Attacks). It seems to me that your condition is fairly stable.
The other issue is is whether there is Alzheimers process going on? Was the doctor definitely able to determine this? Even if there is a certain level of alzheimers disease process, I would not think that you are at the accepted range of moderate to severe where Namenda has be seen to be beneficial. From your writings alone, I don’t think you are anywhere near this stage.
The only responsible advice I can give is to discuss your concern about the effects of the Namenda, on your function and emotions, with your doctor. However, from what I have heard and read, I think that being able to successfully take Aricept is more likely to be beneficial for you at this time – if the doctor is able find a way that you could tolerate the med.
The purpose of both of these meds it to enhance a person’s function. If they are causing more problems than benefits… well, you need to discuss this with the doctor.
Norbert
Bobute, Mes milet tevi
(greeting from neighboring Latvia)
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