LS Fisher, Alzheimer’s Journey, September 22, 2011
Alzheimer’s disease cannot be cured, but is treated with a combination of cognitive and behavioral drug therapy, together with behavior modification techniques. Alternative non-drug treatments can be used in combination with conventional treatment when approved by your physician. Medical management of your Alzheimer’s symptoms and treatment of other co-existing medical conditions is essential to your wellbeing.
Researchers continue to explore different avenues of Alzheimer’s treatment. The U.S. Food and Drug Administration (FDA) is responsible for approving all drugs used in the treatment of Alzheimer’s. Some drugs show promise in early tests but are never approved by the FDA because of side effects or inconclusive evidence of their effectiveness.
Drugs must pass rigorous testing and clinical trials before they are approved by the FDA. This process takes several years. Drugs are in development that are intended to slow or stop the disease process by targeting brain changes associated with Alzheimer’s.
Currently approved drugs slow cognitive symptoms for six months to a year. None of these drugs will cure Alzheimer’s or slow the progression of the disease. Some family members and people with Alzheimer’s find symptoms may be helped for much longer, but research does not support this conclusion. Your physician may continue to prescribe cognitive medication as long as it appears to be effective.
FDA approved drugs:
• Aricept: Used for all stages
• Razadyne: Mild to moderate stages
• Namenda: Moderate to severe
• Exelon: Mild to moderate
Aricept, Exelon and Razadyne are cholinesterase inhibitors. Namenda regulates glutamate, a chemical released by damaged brain cells. Namenda can be used in combination with one of the cholinesterase inhibitors. Researchers believe the solution to an effective Alzheimer’s treatment will be development of drugs that work in combination to target different aspects of the disease.
Alzheimer’s affects the entire brain including the frontal lobe that controls behavior. Caregivers often report that behaviors are the most stressful aspect of Alzheimer’s. Behavior modification techniques, as well as drugs, are used to deal with aggression, sleeplessness, agitation, wandering, anxiety and other behaviors. It is important to analyze what occurred before the behavior. By determining the behavior trigger, it may be possible to eliminate the cause without using drugs. If drugs are necessary, your physician may prescribe anti-depressants, sedatives, mood stabilizers or other drugs approved for Alzheimer’s behaviors.
Some behaviors are upsetting to family members. Your reaction may have no effect on the behavior, but calm reassurance may lessen the behavior. As long as a behavior is not harmful, reassurance and validation of your loved one’s feelings may be all that is necessary. Maintaining a daily routine is helpful to avoid bad behavior triggers.
Deteriorating language skills can cause angry outbursts when your loved one cannot express the words to communicate with you. Listen carefully and respond calmly. Reassure your loved one that you care and respectfully validate her concerns. Avoid arguing, talking down to the person, or using a form of baby talk known as elderspeak.
Behavior modification techniques are often learned from other caregivers and online research. Check with your local Alzheimer’s Association Chapter for a support group in your area.
You may benefit from using alternative treatments that are not FDA approved. Before using herbal remedies or dietary supplements, check with your physician for possible drug interactions. You may think that because herbal remedies are natural, they are safe, but some create changes in your body that might either counteract your medication or enhance it too much for safety.
Alzheimer’s drugs are expensive and you might need to be creative to afford treatment. If you participate in a clinical trial, you may have the opportunity to try a medication that is not publicly available. These trials often include free evaluations and medications.
More than 90 drugs have been approved by the FDA for clinical trials and other drugs are in the pipeline. Fifty thousand participants are needed for clinical trials in the U.S. Volunteers for clinical trials are screened prior to participation and only one out of 10 is accepted. Each trial has criteria for acceptance and excludes those who do not meet their specific criteria. Studies may require the participant to be able to communicate or fall within an age range. Health conditions not related to Alzheimer’s are a consideration with some clinical trials.
Research projects are available for genetic testing on families who have hereditary Alzheimer’s. Other studies explore the social-psychological aspect of Alzheimer’s.
Your physician may be able to help you find a clinical trial in your area. You can also find clinical trials online at the Alzheimer’s Disease Education and Referral Center (ADEAR) and at the Alzheimer’s Association Research Center’s TrialMatch. Clinical trials are essential to developing drugs which can slow the progression of Alzheimer’s, delay symptoms, prevent or cure the disease.
Alzheimer’s Association Research Center. Clinical Trials. Accessed: July 16, 2011. http://www.alz.org/research/clinical_trials/find_clinical_trials_trialmatch.asp?type=homepage
National Institute on Aging. Participating in Alzheimer’s Research. Accessed: July 16, 2011.