What fever-reducing drug is safe to take with Alzheimer's medications?

Advorani asked...

My mother-in-law is 62 years-old and is probably in the middle to late-moderate stage of Alzheimer's. Her drug treatment includes Namenda, Aricept and Setraline. Considering drug interaction and their side effects, what kind of drug we can offer her in the case of high fever, flu etc?

Expert Answer

Pharmacist William Simonson, also known as "Dr. Si", is a board-certified geriatric pharmacist who is dedicated to improving medication use by seniors. He is a pharmacy educator and is active in publishing and presenting to health professional and consumer audiences and has been active in the area of geriatrics and long-term care pharmacy practice for more than 35 years.

Dementia and managing fever It is rare for someone your Mom's age to have dementia, especially in the moderate to severe stage. It is very important that everyone with dementia receive the appropriate medications and avoid those that can cause further problems such as adverse drug reactions and interactions.

Two of your Mom's medicines, Aricept and Namenda are approved by the US Food and Drug Administration for treating dementia. Each of these medicines has a different mechanisms of action and because of that they are commonly used together with the hope that they will be more effective than just a single drug. Mom's other medication, sertraline, is primarily used to treat depression which may also occur in persons with dementia.

These three medicines are not likely to have significant interactions with the two medicines most commonly used to reduce fever, aspirin and acetaminophen (the active ingredient in the brand name medicine Tylenol). Nor are they likely to interact with antibiotics which may lower fever by treating specific infections. That being said it is important to always check with your pharmacist when you are considering giving a new medicine or supplement to your Mom.

Obviously I don't know the details of your Mom's situation but I feel it is important for me to mention that it is sometimes difficult for physicians to differentiate between dementia and depression when a patient might have either or both conditions. In some patients severe depression might actually look like dementia and proper antidepressant treatment, including non-drug interventions and/or use of the proper medications at the appropriate doses may result in noticeable improvement of dementia symptoms. In fact, I once heard a geriatric psychiatrist respond to question about how to diagnose a patient who might have either dementia or severe depression and he said, "You treat the patient for depression and if they get better they don't have dementia." I only provide that example to underscore the fact that it is challenging to treating someone with both dementia and depression which makes it important that an individual with these conditions receive a thorough evaluation and ongoing treatment from a qualified physician in order to optimize their chance of responding to therapy.