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Question
Posted by: Tango | 2011/04/10

Altzheimers

Dear CS,
I currently work with the above patients. Although challenging I would not stop for anything! Please can you tell me a bit about the following two drugs which seem to be often used.

1. Mirteron
2. Risperdal

Why are they the drugs of choice?
What would be the ideal night medication?

I hope you are well!

Kind regards

Tango

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Our expert says:
Expert ImageCyberShrink

I have no experience in using Mirteron in such situations. It is a generic version of the drug Mirtazapine, and is a newer antidepressant. I don't see why it would have any value at all in someone with Alzheimers, unless they happened to be Depressed, which o course can occur ; and then I'm not aware of any significant advantage it would have over other available antidwepressants. I haven't heard anyone suggest it as a "drug of choice" in such patients.
Of course there is no drug of choice as such in Alzheimers. There are a number of frialy recently available drugs which seem to delay the progression of the disease, but are expensive, and only useful in the early phases of it, if these can be properly identified. Then they may help the individual to remain independent or a lower burden of care, for longer.
Risperdal is an interesting drug, somewhat controversial in this siruation. It is an effective antidepressant, with less Parkinsonian problems than some of the alternatives.
Clinically, it can be extremely helpful in controlling agitation and confusion and restlessness. The snag is that it is one of a number of drugs used in such situations, where research has shown a significantly increased risk of strokes and heart attacks, and mortality. There is still some controversy about the extent of the risk. And about whether the risk is worth it in balance with the advantages of using the drug.
It has been common experience that it can quickly ( especially when used in liquid form ) transform a person from a suffering, terrified, agitated, deluded individual into someone calm, happy, and very much more like their old selves.
Unfortunately, by the time someone has advanced Alzheimers ( or some other form of dementia ) it's too late to discus this with them and ask their wishes. I know if I develop dementia, I devoutly hope someone will treat me with Risperdal !

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1
Our users say:
Posted by: cybershrink | 2011/04/11

I have no experience in using Mirteron in such situations. It is a generic version of the drug Mirtazapine, and is a newer antidepressant. I don't see why it would have any value at all in someone with Alzheimers, unless they happened to be Depressed, which o course can occur ; and then I'm not aware of any significant advantage it would have over other available antidwepressants. I haven't heard anyone suggest it as a "drug of choice" in such patients.
Of course there is no drug of choice as such in Alzheimers. There are a number of frialy recently available drugs which seem to delay the progression of the disease, but are expensive, and only useful in the early phases of it, if these can be properly identified. Then they may help the individual to remain independent or a lower burden of care, for longer.
Risperdal is an interesting drug, somewhat controversial in this siruation. It is an effective antidepressant, with less Parkinsonian problems than some of the alternatives.
Clinically, it can be extremely helpful in controlling agitation and confusion and restlessness. The snag is that it is one of a number of drugs used in such situations, where research has shown a significantly increased risk of strokes and heart attacks, and mortality. There is still some controversy about the extent of the risk. And about whether the risk is worth it in balance with the advantages of using the drug.
It has been common experience that it can quickly ( especially when used in liquid form ) transform a person from a suffering, terrified, agitated, deluded individual into someone calm, happy, and very much more like their old selves.
Unfortunately, by the time someone has advanced Alzheimers ( or some other form of dementia ) it's too late to discus this with them and ask their wishes. I know if I develop dementia, I devoutly hope someone will treat me with Risperdal !

Reply to cybershrink

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