Dementia Drugs Often Taken Longer Than Clinical Evidence Supports

About 70% of people that take a medication for dementia take it for longer than clinical evidence shows the drug is beneficial, increasing the risk for side effects from long-term use.

A new report from the AARP Public Policy Institute examined claims on almost 71,000 Medicare Advantage enrollees who were diagnosed with dementia. About half of them received a medication for dementia. Of those who received a drug, 58% received a cholinesterase inhibitor such as Aricept (donepezil), Razadyne (galantamine) or Exelon (rivastigmine). A third were prescribed a cholinesterase inhibitor and Namenda (memantine) and 8% were prescribed Namenda alone.

Although clinical evidence has demonstrated that these medications may delay cognitive impairment for up to 12 months – while some patients will not see any benefit – there is no evidence that they are effective beyond that timeframe. Yet, 70% of those on a dementia medication in the study were on one for 13 months or more.

The authors noted that cholinesterase inhibitors have been associated with fainting, hip fracture and unusually slow heartbeat. Side effects associated with Namenda include dizziness, confusion, headache, sleepiness, constipation, vomiting, pain (particularly back) and coughing.

“Accessible and up-to-date information on a drug’s effectiveness and side effects is essential to help increase the practice of de-prescribing medications that may no longer be of benefit, or even cause harm,” the researchers conclude.

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