Can melatonin be given with Aricept? And if you're on Aricept should the DMV be notified?

A fellow caregiver asked...

My mother is almost 76. She has been on Aricept for at least a year. I understand that the "PM" version is not recommended, however, my mother often wakes up around 2:00 in the morning and can't get back to sleep. Can she be given melatonin safely (without it interfering with her meds)? Also, on another note, when someone is put on Aricept, it would seem logical that a physician has identified a definite condition that is declining. At that point, if the impairment is that noticeable, should the doctor notify DMV and recommend the person to stop driving?

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

In a well controlled study, melatonin was not found effective in promoting sleep in persons with dementia. Aricept does not help sleep either, it actually could disrupt sleep if given in the evening by causing nightmares. Aricept is sometimes prescribed even for people with mild cognitive impairment that is limited to memory and might not affect their driving. However, with progression of cognitive impairment driving problems may arise. There are differences from state to state in a requirement of doctors to notify DMV when somebody develops dementia. You might need to monitor your mother closely and talk to her about stopping driving if you feel she is an unsafe driver.