I came across two very interesting articles, both from the Annals of Internal Medicine, 2008 Mar 4;148:370 and Mar 4;148:379.
These article authors reviewed an astounding 59 randomized clinical trials testing Alzheimer’s Disease medications which are on the market including: Aricept, Exelon, Namenda, Razadyne and Tacrine.
Here are their conclusion:
“…, based on an extensive evidence review, …-in particular, that these medications do not lead to dramatic clinical improvements for dementia patient. In the editorialist view, “development of new agents with more-meaningful clinical benefits should be a high priority than further research on the currenly available ones (Richard Saitz, MD MPH FACP FASAM).
This tells me once again that the current medications have very limited value but are helpful for some subjects. I recommend after 6 months if the pt and family do not note any “meaningful” stablization of functional ability or continued decline is noted, or side effects (wt loss, increased confusion, urinary incontinence, etc.) to discuss with the prescribing doctor the possiblity to wean off the medication. Consideration of reseach participatin should always be part of a dialogue among the pt, caregiver and physician.