Having an individual who is diagnosed with severe Alzheimer’s disease can cause extreme burden on caretakers. Alzheimer’s is the decrease in brain availability. Alzheimer’s disease is a stressor in itself, because the disease causes individuals to have difficulty with cognition, ultimately reducing memory and events. There are a number of concerns in the treatment process involving this disease. The question of involving medicine to improve the treatment process of an individual with Alzheimer’s is discussed in this article.

The use of medication(s) is a concern in the treatment of the disease. Acetyl cholinesterase inhibitors, just to name a few, are available drugs to treat Alzheimer’s at a slightly smaller range of the diagnosis. The use of Memantine is used to treat Alzheimer’s disease at a more profound level. This medicine has also been known to be effective in the treatment of a more profound level of the disease. The literature goes on to search the best and effective way of treating the disease.

The first study focuses on the use of Acetyl cholinesterase inhibitors with Donepezil in treating Alzheimer’s patients with a more profound level of the disease. 290 patients were randomized to treatment in this 24-week, double blind, placebo-controlled trial (Feldman, Gauthier & Hecker, 2001). Patients received either donepezil 5mg per day for the first 28 days and 10 mg per day thereafter (Feldman, Gauthier & Hecker, 2001). In addition, a 24-week, randomized, parallel-group, double-blind trial conducted in 27 nursing homes across the United States, patients who were treated with donepezil (Feldman, Gauthier & Hecker, 2001).

Another study was conducted with the Cognitive abilities being tested by the ADAS-cog scale of patients with moderate advanced Alzheimer’s who received Galantamine for 12 months (Blesa, Davidson & Kurz, 2003). There was an additional group of two dosage groups of Rivastigmine 1-4 or 6-12 mg per day was assessed in patients with Alzheimer’s disease who were stratified according to their baseline severity (Doraiswamy, Krishman & Anand, 2002).  In the study by Reisberg, (Reisberg, Doody & Stoofler, 2003), patients with moderate to severe Alzheimer’s disease were randomly assigned to receive either Memantine 20 mg per day or placebo for 28 weeks; with 252 patients with the average age of 76 years old were enrolled. In another study, (Tariot, Farlow, & Grossberg, 2003), published the first prospective, double-blind, placebo-controlled study examining the benefits of NMDA (Memantine) in patients with moderate to severe Alzheimer’s who were receiving a stable dose of the Cholinesterase inhibitor, Donepezil; starting with 5 mg per day which was increased to 20 mg per day for 2 weeks.

The uses of Donepezil and Memantine have been shown to cause a better treatment process in severe Alzheimer’s patients. A combination of both medications has an improved effect on symptoms of this disease. Beginning this treatment at the onset of the disease could help to slow the process of the disease. The use of these meds also is helpful for the caregiver of an Alzheimer’s patient and their treatment.

Blesa R, Davidson M, Kurz A, et al. Galantamine provides sustained benefits in patients with ’advanced moderate Alzheimer’s disease for at least 12 months. Dement Geriatr Cogn Disord 2003; 15 (2): 79-87

Doraiswamy PM, Krishnan KR, Anand R, et al. Long-term activities of donepezil and   other cholinesterase inhibitors on effects of rivastigmine in moderately severe Alzheimer’s disease: does early initiation of therapy offer sustained benefits? Prog Neuropsychopharmacol Biol Psychiatry 2002 May; 26 (4): 705-12

Feldman H, Gauthier S, Hecker J, et al. Donepezil MSAD Study Investigators Group. 24 week randomized, double- blind study of donepezil in moderate to severe Alzheimer’s    disease. Neurology 2001; 57: 613-20

Reisberg B, Doody R, Stoffler A, et al. A randomized placebo-controlled study of   memantine, an uncompetitive NMDA antagonist, in patients with moderate to severe Alzheimer’s disease. N Engl J Med 2003; 348: 1333-41

Tariot PN, Farlow MR, Grossberg GT, et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA 2004 Jan 21; 291 (3): 317-24