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Home » Health » Chattanooga: Costly medicines ...
Monday, Oct. 20, 2008

Chattanooga: Costly medicines prompt some to question Alzheimer’s treatments

Doctors today have a number of medications to treat the cognitive symptoms of Alzheimer’s disease.

Drugs such as Aricept and Exelon prevent the breakdown of a brain chemical that acts as a messenger and is key for learning and memory function, according to the Alzheimer’s Association.

Another common Alzheimer’s medicine is Namenda, which regulates the activity of glutamate, another body chemical involved in learning and memory.

The drugs often are used in combination in an effort to slow the progression of Alzheimer’s, said Dr. John Standridge, director of the geriatric medicine fellowship program at the UT College of Medicine in Chattanooga.

“They’re the first medicines we’ve had that actually do make a difference,” he said.

Other drugs can treat the behavioral symptoms of Alzheimer’s, such as antipsychotic drugs and antidepressants.

But the caretakers of some local patients question how long the drugs should be continued.

Renee Trent, of Chattanooga, said if the drugs do anything, they just put off the inevitable.

“If I knew then what I know now, I would never have let them put Sam on them,” she said of her husband’s time on the medications. “I would let nature take its course.”

Fifi Ginsberg, wife and caretaker of Joel Ginsberg, a former pulmonary physician, said she, too, questions the effectiveness of the drugs and has talked with his doctor recently about them.

“They’re not helping with his Alzheimer’s anymore,” she said. “They’re costing a lot of money — money I could use for (a helper.)”

Families and doctors acknowledge that the medications dilemma is tough.

The question of when to stop those medications often is prompted by financial concerns, said Dr. John Standridge, director of the geriatric medicine fellowship program at the University of Tennessee College of Medicine in Chattanooga. Though the medications are expensive, the drugs can help keep patients at home and out of a nursing home for a longer time, which can save a lot of money, he said.

“There is also the issue about when the benefits of the medicine are no longer tangible. That is to say, you think their quality of life would be just as good without it. That usually comes later in the progression of the disease,” Dr. Standridge disease.

Some physicians might discontinue medication in a nursing home patient who has severe Alzheimer’s, but others might consider that the patient would be less likely to aspirate food, or experience other discomforts, if the medications continued, he said.

Above all, quality of life should be the paramount consideration when evaluating whether to continue with medications, he said.

“Geriatrics is about comfort and function,” he said.

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