My Mother Begins New Drug

January 28.
Last night my mother started her first week on Memantine, a drug approved by the US Food and Drug Admninistration(FDA) in Oct. 2003 and only available in the American pharmacy shelves this month. Here in the US it will be known as Namenda. Very long term studies are just begninning so we do not know what to expect in that area.

I do not plan to write every day on this as I do not think it will happen overnight, but I will keep a record week to week. Results take time. Namenda is also the same crap shoot or gamble that Aricept was. Mom just got a winning streak from it as she really has had a very slow decline compared to others. I have read that it was approved for moderate to severe AD but I have also read that taken with Aricept it did increase Activities of Daily Living(ADL) and cognition and overall abilities as well as getting to bathroom on time I decided to try it. I have not read any studies of it being used with Aricept's competition and mom has been on Aricept since it was first on pharmacy shelves, so I decided to take the gamble.

At first I just picked the 10mg prescription and thought I would titrate the way mom's doctor wrote out for me but one of the posters on the Alzheimer's list told me that there was a titration pack so that I would not have to split up unscored pills. I called the pharmacy but they did not have them yet. As soon as they arrived I was called and the doctor cooperated in new prescription. I am also happy to report that Medicaid paid for the new script and I can just hold on to the old bottle as I have not cut all of the pills so they should not be losing potency. I am relieved and I am beginning to believe that maybe life is getting just a little bit better.
Feb. 8
My mother is now on the second week of the starter pak and no adverse effects. She has been easier to handle at bath time but she still demands sweets every five minutes or cheese. I do not know why she gets cheese cravings, only that she gets them.

Feb.28
Mom is now on the full strength of 10mg twice a day. She is very sleepy and hard to keep out of bed during the day when the aide is not here. It seems it is easier for her to keep my mother awake than it is for me. I only got her up for her to eat, the rest of the time she refuses to get out of bed. However she is not getting up in the middle of the night trying to escape etc so I guess I can wait for the doctor visit later in the week.
She has not shown any signs of it having any effect except for the possibility that it might the cause of her drowsiness.

March 27
I don't see much difference but at least she is still functioning as well as she did before she started taking it. The weather has been great so she walks every day with her attendant.

April 1
I still do not see any change in mom. However at least she is not any worse. I have also had days when she only gone one pill because I forgot to giver her the morning dose. So it might still work for her. At least she is not getting any worse.

July 25 2004,
I do not see any changes adverse or otherwise. I do not know if it is helping. She still needs to have a full rounded day or she goes to bed later than 9:30pm. I had some days in which she woke me up to ask for breakfast and it was only 4 AM but then I noticed a pattern and it was day care. If they let her get away with just having the fruit plate for lunch then it is just empty meal and she will be hungry at home and so have more energy to be unhappy and make me miserable late at night. So I do not blame the Namenda(also known as Memantine)

Her activities of daily living have not further declined. She can still dress, toilet, and feed herself with minimal coaching. she does not need to be told to brush her hair. she has begun to use more Yiddish. She keeps referring to her red hair in its Yiddish translation and call me by my yiddish name even though it was not her first language. Not sure what it means. Prabably nothing. However I kind of like it. She also remembers some Jewish rituals and that moves me.

Oct 6 2004
I do not know if it is coincidence or because of the medication but my mother has been very easy going and pleasant both at the day care and at bath time.
The home attendant who has been with us for over 7 years has just started maternity leave. Mom asks about her and wishes her well. I am surprised by that as I thought she would not be able to remember.

April 11, 2005

Mom had a great birthday celebration yesterday but when I went to wake her, she had wet the bed. I am getting conflicting advice about her need for a new queen size bed or twin or hospital type bed. I do realise it is time for the big diapers, depends at night not the panty liners she wears. I ordered the new queen when they gave me the same price as for a twin. I do not think she will be in a wheel chair any time soon. She can walk for thirty minutes on a pedestrian path near a highway and residential area, she is not going into a wheel chair so soon. I now know that to clean up such stains that I have to use the same products that people who own animals use to clean up those messes on carpets and beds. An Enzyme product not a fabric cleaner.

as for daytime, she seems to be fine, no complaints from the day care people.

I am not sure now about Namenda. The first year has ended yet she is wearing full time panty liners.

May 2005
Unfortunately this is not a good springtime for us. Mom had a day in which she thought the long time home attendant was someone else and she did not recognize me either and asked about Penny. She also thought that her husband was still alive. She thought the home attendant photos were of someone other than the woman was presently with her. That was actually during the holiday of Passover. Now that it is over she has a better family memory but her incontinence is getting worse. She had a bm in her diaper one afternoon. It is usually urine. I wonder often if her prolapsed bladder makes it worse. I want to thank the members of the Alzheimer's discussion List for advice on taking care of the mattress and cleaning sheets. I highly recommend them. Their address and archives are at www.adrc.wustl.edu/alzheimer It is the medical school of Washington U In St. Louis that owns the site and list. I cannot praise them enough. I am also quite happy with the doctors and staff at Mount Sinai Medical Center here in NYC. I take mom to their Coffey Geriatrica Clinic. All the staff there are really caring. Mom's doctor is no longer taking any new patients so I cannot use her name. However she was not the first geriatrician we saw so I am confident in recomending them to anyone who is in our area. They also have an Alzheimer Disease Research and Education Center. So drug trials are also possible.

Links to other sites on the Web

Alzheimer's Association
Namenda
FDA
Nat'l Institute on Aging(NIA)
American Geriatrics Society
Alzheimer's DiseaseStages