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Alzheimer's Disease

Starting Aricept Treatment While Testing

10/31/2006

Question:

My father is experiencing mild - moderate cognitive impairment. After a visit with his doctor that included a brief discussion of the kinds of mental challenges he is having he was given a prescription for Aricept. I inquired about performing blood tests, brain scan, etc to rule out causes of dementia other than AD and was told that we could start him on the medication and proceed with the other tests. Is there any harm in following this recommendation?

Answer:

I'm with you. I would like to find the cause of something before starting a medication. What if the cause of the mental confusion is due to something other than AD? Then you may not be getting the best treatment for that condition and you are wasting money and possibly getting side effects from a medication that is not needed. If the work up is done quickly to include blood tests, a scan of the brain, and cognitive testing, then it won't make much difference if Aricept is started a week or two later. Fortunately, in practice, Aricept is so well tolerated that the risk of adverse events is uncommon. Also, if AD is the cause, then starting a medication early is a goal.

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Response by:

Douglas W Scharre, MD Douglas W Scharre, MD
Clinical Associate Professor of Neurology
Clinical Associate Professor of Psychiatry
College of Medicine
The Ohio State University