- Joined
- Jun 16, 2010
- Messages
- 181
- Reaction score
- 3
Honestly, I often feel as though I'm flipping a coin on this one.
Aside from contraindications (COPD, GI ulcer or cardiac conduction problems w/ aricept and renal considerations with Namenda), I'm usually ambivalent about choosing one over the other.
Neglecting cost (surprisingly Namenda is cheaper according to epocrates), what considerations do you take into account when selecting on one of these agents?
I have recently wondered if cholinesterase inhibitors might not be the best choice with respect to mood:
http://www.psycom.net/depression.central.cholinergic.html
And if it's more appropriate to prescribe cholinesterase inhibitors in the morning vs. evening with respect to memory consolidation (the two links below appear to conflict on this question):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC357065/
http://www.ncbi.nlm.nih.gov/pubmed/17141741
Also, might namenda be preferred for those with alcohol, other SUD's or other psychopathologies related to the NMDA receptor (i.e. anxiety?)
http://ajp.psychiatryonline.org/cgi/content/full/164/3/519
Might the combination of namenda and aricept be neurotoxic in humans?
http://www.ncbi.nlm.nih.gov/pubmed/17112636
Lastly, I'm completely scratching my head with this new 23 mg indication for Aricept. When is this dose preferrable to 10 mg/day and how much more significant are side effects at 23 mg vs 10 mg?
And the Exelon patch??
Please, share your knowledge on this topic. Any related information on these medications' effects on sleep, medical or psychiatric comorbidities (especially dementia-related psychosis and behavioral disturbances), relvevant polypharmacy or off-label use (including substance-induced dementias) would be appreciated.
Aside from contraindications (COPD, GI ulcer or cardiac conduction problems w/ aricept and renal considerations with Namenda), I'm usually ambivalent about choosing one over the other.
Neglecting cost (surprisingly Namenda is cheaper according to epocrates), what considerations do you take into account when selecting on one of these agents?
I have recently wondered if cholinesterase inhibitors might not be the best choice with respect to mood:
http://www.psycom.net/depression.central.cholinergic.html
And if it's more appropriate to prescribe cholinesterase inhibitors in the morning vs. evening with respect to memory consolidation (the two links below appear to conflict on this question):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC357065/
http://www.ncbi.nlm.nih.gov/pubmed/17141741
Also, might namenda be preferred for those with alcohol, other SUD's or other psychopathologies related to the NMDA receptor (i.e. anxiety?)
http://ajp.psychiatryonline.org/cgi/content/full/164/3/519
Might the combination of namenda and aricept be neurotoxic in humans?
http://www.ncbi.nlm.nih.gov/pubmed/17112636
Lastly, I'm completely scratching my head with this new 23 mg indication for Aricept. When is this dose preferrable to 10 mg/day and how much more significant are side effects at 23 mg vs 10 mg?
And the Exelon patch??
Please, share your knowledge on this topic. Any related information on these medications' effects on sleep, medical or psychiatric comorbidities (especially dementia-related psychosis and behavioral disturbances), relvevant polypharmacy or off-label use (including substance-induced dementias) would be appreciated.
Last edited: