Hi, this is Teri. I am a 3rd generation Alzheimer’s Survivor and a co-caregiver of a parent who is surviving and thriving despite having Alzheimer’s Disease.
I owe some Alzheimer’s Survivors an apology! Last week’s Zoom call filled up and exceeded the limit of people who can join. Each week the number of attendees has increased. I thought it would take months before we exceeded the maximum attendance. Nope – it only took 3 weeks! I have upgraded my package so 300 people can join at a time now.
Over the last few weeks, we reviewed the Leqembi and Kinsunla amyloid-targeting medications for Alzheimer’s Disease. I hope those discussions encouraged a few of you to reach out to a research clinic or neurologist to schedule an appointment for a memory screening.
But before we go any further, I will remind you, that I am not a doctor. I am not a medical professional. I am a person who can take detailed medical information, research it, and create content & imagery that will make it easier for you to understand a specific concept. You should NEVER use my content to make medical decisions for yourself or your loved one. However, you can take the content I provide to begin conversations with your doctor.
This week I want to talk about other medications that are available to treat Alzheimer’s Symptoms. This category of medications is called Cholinesterase Inhibitors.
What are Cholinesterase Inhibitors?
Google’s AI tells us that cholinesterase inhibitors (ChEIs), also known as acetylcholinesterase (AChE) inhibitors or anticholinesterases, are a group of drugs that prevent the breakdown of acetylcholine (ACh). ACh is a chemical messenger that's important for memory, learning, language, judgment, and other thinking skills. By increasing ACh levels and duration of action, ChEIs can improve communication between nerve cells and support their functions.
ChEIs are most commonly used to treat neurogenerative diseases like Alzheimer's disease, Parkinson's disease, and Lewy body dementia.
For example, in Alzheimer's, lost nerve cells can lead to lower levels of ACh, which can make it harder for brain signals to be sent. ChEIs can help improve symptoms by making more ACh available to healthy nerve cells.
What Cholinesterase Inhibitors are available to take?
Aricept
Aricept is used to treat dementia caused by Alzheimer's disease. Aricept can help improve attention, memory, behavior, and ability to do daily activities in dementia patients.
Aricept is not a cure for Alzheimer's disease; it may help improve symptoms, but the condition will progress over time, even in people who take this medicine. Aricept generic name is donepezil.
Aricept improves the function of nerve cells in the brain. Aricept works by preventing the breakdown of a chemical called acetylcholine (ah SEET il KOE leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.
Exelon
Exelon improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical that is important for the processes of memory, thinking, and reasoning. People with dementia usually have lower levels of this chemical.
Namzaric
Namzaric contains a combination of donepezil and memantine. Donepezil improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine. People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning. Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease.
Razadyne
Razadyne is used to treat mild to moderate Alzheimer's type dementia by improving the function of nerve cells in the brain. Razadyne works by increasing the amount of a natural substance in the brain called acetylcholine which is needed for processes of memory, thinking, and reasoning.
Cholinesterase Inhibitors side effects?
Cholinesterase inhibitors can have many side effects, including:
- Gastrointestinal issues: Nausea, vomiting, diarrhea, loss of appetite, dyspepsia, and anorexia
- Muscle issues: Muscle cramps, muscle twitching, and prolonged muscle contraction
- Other issues: Headaches, insomnia, dizziness, lightheadedness, weakness, weight loss, and vivid dreams
Some side effects may be more concerning, such as lightheadedness, weakness, and weight loss. Higher doses are more likely to cause side effects, but starting treatment at a low dose and working up to a higher dose can help. Taking these medicines with food, preferably a full meal, can also help lessen some side effects.
Vivid dreams are barely mentioned as a side effect in all of the drug literature. However, when I was working in the pharmacy, I saw more people stop taking Aricept due to experiencing horrible nightmares and additional daytime confusion. Their doctors would usually move them to another solution like Memantine. Therefore the patient never benefited from an uplift in acetylcholine. If you are prescribed a cholinesterase inhibitor, please start with a very low dose. Slowly building up to a full dose over a few months.
How much does it cost?
The cost of cholinesterase inhibitors (ChEIs) can vary depending on the drug, dosage, and quantity prescribed. According to GoodRx, some popular ChEIs and their prices include:
- Aricept (donepezil): As low as $13
- Exelon (rivastigmine): As low as $21
- Razadyne ER (galantamine ER): As low as $88
Some patients may be eligible for a Disability Allowance to help cover the cost of ChEIs. For those without insurance, other options may include manufacturer coupons, patient assistance programs, or a prescription discount savings card.
Is supplementation an option?
You can buy Choline and Acetylcholine to supplement your nutrition. I encourage Choline supplementation for anyone over 40. You will want to choose an excellent quality solution. The supplements I encourage are the following:
Pure Encapsulations Choline: https://amzn.to/3XfXoBX
Standard Process Choline: https://amzn.to/3X0mV0E
Both cost about $20.
I encourage Choline over Acetylcholine. Why? Your body will take choline and metabolize or convert it to acetylcholine. Making the acetylcholine your body creates more absorbable.
Is it worth it?
Absolutely!! I think it is!
As I have said before, I do not understand why someone who is experiencing memory loss would not do everything in their power to limit or reverse their cognitive health. Taking choline in addition to lifestyle changes will go a long way to preventing cognitive decline.
Is it worth it to you?
Only you can decide.