Alzheimer's Meds: Time for a Reality Check?
Last updated: Apr 05, 2008
Who doesn't wish for a pill to make Alzheimer's go away ? Unfortunately recent headlines underscore that, for now, caregivers need to focus their energy on learning how to prevent and manage symptoms through behavioral therapies.
A quick recap:
* " Medication worsens Alzheimer's ." A UK study has found that antipsychotic drugs such as Melleril and Risperdal used to treat hallucinations, aggression, and agitation in dementia patients -- usually in nursing homes -- offer no benefit, especially over the long term, and worse, often cause a decline in speaking ability.
* " Only modest evidence of clinically meaningful benefit. " That's how two major medical groups -- the American College of Physicians and the American College of Family Physicians -- summed up their joint study into the five dementia-specific drugs used to treat memory loss and cognition, such as Aricept and Namenda, last month. Basically the meds studied were deemed pretty much alike and of little use for the average patient (though doctors should assess each patient individually as some do show improvement).
* " The drug industry has bet heavily on one theory of the disease. What if that theory is wrong? " Even the busy drug pipeline has an iffy forecast, according to this Forbes overview , which points out that the drug industry is betting heavily on targeting amyloid clumps in the brain, though it's not yet certain that these are the cause of dementia. Hopefully this research will help us (or our kids to help us) but it's unlikely to make a practical difference in the very near future.
Behavioral therapies aren't "once a day" and can't make the burden of dementia care go away. But they can help enormously. The Dementia Caregiver's Toolbox , for example, just shared new info about adjusting light levels at home to ease sundowning. I know my own caregiving life turned around once I learned the power of nonverbal communication with Alzheimer's, like touch to signal my presence or hand signals to reinforce my message. One could even argue that such tips can change a life more than a pill.
Image by Flickr user noricum , used under the Creative Commons attribution license.