Thursday, February 21, 2008


Terry Bankert

Summary at Flint Talk


I have spent the last 90 days involved in the decline of a parent. As a boomer I am amazed at how many people I know are involved in this now. Mabey I am just more sensitive to information about declining parents. Today I am looking at the drug Aricept.

The hand out literature says it is Donepezil used to treat moderate Dementia. The Side affect c an be Nausea, vomiting, diarrhea, loss of appetite, tiredness, drowsiness, trouble sleeping, muscle cramps.

A google found the following:


What treatments are available?
Currently, there is no cure for Alzheimer's disease (AD). ... For those who are currently suffering from AD, there are medications that can help control symptoms of the disease. In addition, medication treatments are also available to help manage agitation, depression, or psychotic symptoms (hallucinations or delusions), which may occur as the disease progresses. [ah]


Aricept (Donepezil): Aricept (Donepezil) is indicated for the treatment of mild to moderate Alzheimer's disease. Aricept does not affect the progression of the disease and, as Alzheimer's worsens, the drugs' effectiveness will lessen too. ...lessen the occurrence and severity of other symptoms of Alzheimer's such as anxiety, agitation, agression, and depression. [g]


FDA-Approved DrugsThere are five Food and Drug Administration (FDA)-approved drugs that can control symptoms and slow the progression of AD. Cognex® (tacrine), Aricept® (donepezil), Exelon® (rivastigmine), and Razadyne® (galantamine) slow the metabolic breakdown of acetylcholine, and make more of this brain chemical available for communication between cells. It has been known for some time that those suffering from AD have low levels of acetylcholine (an important brain chemical involved in nerve cell communication). This helps slow the progression of cognitive impairment and can be effective for some patients with AD. All of the medications mentioned above are approved for the treatment of mild to moderate symptoms of Alzheimer’s disease; however, in 2006, the FDA approved Aricept for the management of severe AD symptoms based on several clinical trials. Namenda® (memantine) was the first drug approved for the treatment of moderate to severe AD. Namenda is an NMDA receptor antagonist, and appears to protect the brain's nerve cells against excess amounts of glutamate, a messenger chemical released in large amounts by brain cells that are damaged by pathological processes associated with AD. [ah]

Does spending time with your loved one mean everything to you? If your loved one has Alzheimer's, Aricept® (donepezil HCl tablets) may help. Among available treatments, Aricept is the only one approved for all stages of [a]
Alzheimer's disease.
It can help in the mild, moderate, and severe stages[a]

Alzheimer’s is perhaps the most feared disease of old age. Called "the gray plague," it makes once vibrant people debilitated and dependent (see my book, Tangled Minds: Understanding Alzheimer’s Disease and Other Dementias; NY: Dutton, 1998).[g]

It’s not surprising that family members of those afflicted are desperate for a treatment. It’s not surprising that physicians are eager to have something to offer—and one after another, the various proposed remedies have proved worthless or even harmful, including estrogen and Rofecoxib (Vioxx). [g]


While there is no cure for Alzheimer's disease, medical treatments are available to manage symptoms of the disease. Once-a-day prescription Aricept (donepezil hydrochloride) can improve cognition and maintain patient function in people with mild to moderate Alzheimer's disease. In a progressively degenerative disease such as Alzheimer's, improvement, stabilization or a less-than-expected decline is considered a positive response to treatment. These types of responses have been observed in patients treated with Aricept in clinical trials. Individual responses to treatment may vary.[DG]


Persistent treatment with Aricept® (donepezil hydrochloride) may have delayed dementia-related nursing home placement for Alzheimer's patients for close to two years (21 months), according to a new study. These results were presented recently at the 14th annual meeting of the American Association for Geriatric Psychiatry.[DG]

Are there drugs that can delay the onset of Alzheimer's disease?

Aricept (donepezil), an Alzheimer's disease treatment drug appears to have a slowing effect—though limited—on the progression from mild cognitive impairment to Alzheimer's disease, according to a study published in the April, 2005 edition of the New England Journal of Medicine. [ah]

These patients had the memory-related variety of mild cognitive impairment, a transitional stage between the forgetfulness of normal aging and the more serious memory decline and other problems associated with Alzheimer's disease. Over the first year of the three-year trial, mild cognitive impairment patients treated with Aricept had a reduced risk of progressing to Alzheimer's disease compared to patients who took placebo, an inactive pill. The study found the effect of the Aricept treatment lasted longer (up to two to three years) in those patients carrying the ApoE4 gene. Previous studies have shown those with the ApoE4 gene have a higher propensity to develop Alzheimer's than the general population. The findings of this study open the door for discussion of donepezil treatment on an individual basis for patients with mild cognitive impairment. Source: Mayo Clinic, Rochester and the National Institute on Aging


Donepezil (Aricept), a drug used to help preserve brain function in patients with Alzheimer's disease, does little it seems to help control the agitation often seen in patients with Alzheimer's disease, according to a report in this week's New England Journal of Medicine.[r]


Was approved for the treatment of mild to moderate Alzheimer's by the FDA in 1996, and for the treatment of severe Alzheimer's in 2006 [a]

Was shown in studies to help cognition and function, which includes effects on memory and performing everyday tasks [a]

Is the #1 prescribed Alzheimer’s drug—worldwide, more than 3.8 million people have been treated with Aricept [a]

Is part of a class of medicines known as cholinesterase inhibitors [a]

Comes in 2 strengths, 5-mg and 10-mg. Your health care provider will determine the correct dose for your loved one. [a]

Is available in tablets and orally-disintegrating tablets (ODT) [a]

Is well tolerated [a]

How Aricept Can Help

New research has found that donepezil (known commercially as Aricept) is no more effective than a placebo at tackling the agitation which often accompanies Alzheimer's disease.
The findings, published in the New England Journal of Medicine, result from the CALM-AD trial which was set up by the Medical Research Council to look into the potential use of donepezil, to address the behavioural symptoms associated with Alzheimer's disease. Donepezil is part of a family of drugs called cholinesterase inhibitors which are primarily used to help enhance cognitive function. [nmn]

A significant proportion of Alzheimer's patients suffer from behavioural disturbances which are particularly distressing for both patients and their caregivers. Amongst the most troubling of these are symptoms grouped under the term 'agitation' which lead patients to pace, wander, shout or become aggressive. These symptoms are particularly hard to manage, both in the home and in residential care settings and have traditionally been addressed by sedation through the use of tranquilisers. [nmn]

Researchers have tested Aricept on people with mild and moderate Alzheimer’s. They also tested it on those with severe Alzheimer’s. The studies showed that Aricept helps cognition and function, which includes effects on memory and performing everyday tasks. Here are findings from 3 of the studies on which the FDA based its approval of Aricept:[a]

In this study, the time to placement in a nursing home was analyzed for 671 patients with mild to moderate Alzheimer's disease who had participated in one of three clinical trials with Aricept versus a placebo, followed by studies where everyone took Aricept. Patients' caregivers were interviewed to obtain information on the dates and reasons for nursing home placements that lasted for two weeks or more. Patients were categorized according to the length of effective treatment (5 mg or 10 mg a day) with Aricept (donepezil hydrochloride) during the clinical trials and follow-up studies.[DG]

Using statistical analyses, times to nursing home placement for dementia-related reasons were estimated based on different periods of drug treatment. These time estimates took into account each patient's age, gender, and severity of illness as measured by Mini-Mental State Examination (MMSE) scores at entry into a clinical trial, as well as change in caregiver and the patient's use of other cholinesterase-inhibiting drugs after completing participation in the Aricept (donepezil hydrochloride) clinical trials.[DG]

This study showed that patients who received Aricept for longer periods (an effective dose of at least 5 mg a day for at least nine to 12 months) had a 21-month longer delay in nursing home placement than patients who received no or limited Aricept (placebo, or less than 5 mg a day, or at least 5 mg a day for less than 80 percent of the time during a clinical trial).[DG]

15-week study

A 15-week study looked at Aricept in people with mild to moderate Alzheimer's. The study compared 2 groups. One of the groups took Aricept. The other group took a placebo (sugar pill). Each group took tests that measured their thinking, memory, and how they functioned in daily life, including effects on behavior. The researchers found that:[a]

Compared with the placebo group, the typical patient who took Aricept showed improvement on the ADAS-cog test, which measures how well they think, remember, communicate, and figure things out [a]

Patients who took the placebo did worse on the ADAS-cog test during the same period of time [a]

Compared with the placebo group, about twice as many patients taking Aricept showed clinical improvement in the CIBIC-plus test, an interview that measures a person’s ability to function [a]

30 Week Study

A 30-week study also looked at Aricept in people with mild to moderate Alzheimer’s. In this study, one group took Aricept. The other group took a placebo (sugar pill). Both groups took tests to measure thinking, memory, and the ability to function in daily life, including effects on behavior. Researchers compared the results to see if Aricept improved or maintained these functions. The researchers learned that:[a]

Compared with the placebo group, patients taking Aricept scored better on the ADAS-cog test over a 6-month period [a]

Compared with the placebo group, about twice as many patients taking Aricept showed clinical improvement in the CIBIC-plus test, an interview that measures a person’s ability to function [a]

6-month study

A 6-month study looked at patients with severe Alzheimer’s. All of these patients lived in nursing homes. The study compared 2 groups of patients. One of the groups took Aricept. The other group took a placebo (sugar pill). Each group took tests that measured their thinking, memory, and how they functioned in daily life. The researchers found that:[a]

Overall, patients in the Aricept group improved on the SIB test; those in the placebo group declined [a]

As a whole, patients taking Aricept declined significantly less on the ADCS-ADL-severe test than patients in the placebo group [a]

Aricept may not work the same for each person. Some studies have shown that symptoms may improve. If symptoms stay the same—or worsen more slowly than expected over time—this may also mean Aricept is working.[a]

As Alzheimer's disease progresses, your loved one's symptoms may change. Be sure to tell your doctor about any changes. This may help you and your doctor make the best decisions about care and treatment. [a]

The British think tank, NICE (National Institute for Health and Clinical Excellence), which evaluates the effectiveness of drugs and devices, reported last month that the drug’s usefulness is very limited. If it’s helpful to anyone, it’s mainly those with somewhat more advanced Alzheimer’s who stand to benefit.[g]

Is Alzheimer's disease hereditary?
Familial Alzheimer’s disease (FAD) is a rare form of the disease, affecting less than 10 percent of Alzheimer’s disease patients. All FAD is early-onset, meaning the disease develops before age 65. It is caused by gene mutations on chromosomes 1, 14, and 21. Even if one of these mutated genes is inherited from a parent, the person will almost always develop early-onset Alzheimer’s disease. All offspring in the same generation have a 50/50 chance of developing FAD if one of their parents had it. [ah]

Posted here by
Boomer Terry Bankert

—where did this stuff come from
Official Aricept web site

Comments of Terry Bankert
Doctors Guide
Frequently asked Questions
Geriatric Drug Review -- Aricept

News Medical Net
Dr. Gillick

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