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Donepezil For Dementia

donepezil for dementia

Background

Alzheimer's disease is the most common cause of dementia. As the disease progresses, people lose the ability to remember, communicate, think clearly and perform the activities of daily living. Their behaviour may also change. In severe Alzheimer's disease people lose the ability to care for themselves.

The most commonly used treatment for Alzheimer's disease are medicines known as acetylcholinesterase inhibitors. Donepezil is one of these medicines. It is taken as a pill once a day.

In Alzheimer's disease, one of the changes in the brain is a reduced number of nerve cells called cholinergic neurones. These are nerve cells that signal to other cells using a chemical called acetylcholine. Acetylcholinesterase inhibitors, such as donepezil, work by preventing acetylcholine from being broken down. This may improve the symptoms of dementia. However, acetylcholine is also found elsewhere in the body and so drugs of this type may have unwanted effects.

Care plans

Before treatment starts, your current and future health and social care needs will be assessed and a care plan drawn up.

This is a way of ensuring you receive the right treatment for your needs. It involves identifying areas where you may need some assistance, such as:

what support you or your carer need for you to remain as independent as possible – including whether you might need care at home or in a nursing home

whether there are any changes that need to be made to your home to make it easier to live in

whether you need any financial assistance.

These include:

medication for high blood pressure

statins to treat high cholesterol

medicines such as aspirin or clopidogrel to reduce the risk of blood clots and further strokes

anticoagulant medication, such as warfarin, which can also reduce the risk of blood clots and further strokes

medication for diabetes

An antipsychotic medicine, such as haloperidol, may be given to those showing persistent aggression or extreme distress where there's a risk of harm to themselves or others.

Alzheimer's disease medications such as donepezil (Aricept), galantamine (Reminyl), rivastigmine (Exelon) or memantine aren't used to treat vascular dementia, but may be used in people with a combination of vascular dementia and Alzheimer's disease.

Lifestyle changes

The main aim of treatment for vascular dementia is to treat the underlying cause to help stop the condition getting worse.

This will usually involve making healthy lifestyle changes, such as:

  • eating healthily, for example, you may be advised to follow a low-salt diet to manage high blood pressure
  • losing weight if you're overweight
  • stopping smoking
  • getting fit
  • cutting down on alcohol

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