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Canadian study says drugs do more harm than good for MCI
Brezybev
Posted: Wednesday, October 2, 2013 12:42 PM
Joined: 4/24/2013
Posts: 52


I juhttp://www.cbc.ca/news/health/alzheimer-s-drugs-may-harm-people-with-mild-memory-issues-1.1855890s

 

 t read this article this morning. What do you think?

 


Serenoa
Posted: Wednesday, October 2, 2013 2:22 PM
Joined: 4/24/2012
Posts: 483


Interesting study. Thanks for the post. Here is a link for the whole study.

 

http://www.cmaj.ca/content/early/2013/09/16/cmaj.130451.full.pdf 

 

 

It basically looked at a lot of data from previous studies and concluded that there is no benefit to taking these drugs for memory loss. If they are right, how the heck did these things get approved and become so widely accepted by doctors. Although it would not suprise me that this study is right, I would like to see more evidence that these drugs, like Aricept and Namenda, don't help at all.

 

 


Brezybev
Posted: Wednesday, October 2, 2013 6:11 PM
Joined: 4/24/2013
Posts: 52


Thanks Serenoa.

   

 

 Well, even if it does end up being a placebo effect, that can still help some people. What I didn't understand is if it helps people with more than MCI or not.

 

 


Lane Simonian
Posted: Wednesday, October 2, 2013 7:50 PM
Joined: 12/12/2011
Posts: 4586


Thank you, too, for posting this interesting article Brezybev. 


 

I am reading a little between the lines, but I think the reviewers are saying there is a small window in which acetylcholinesterase inhibitors provide symptomatic relief and that is between mild cognitive impairment and mild Alzheimer's disease.  This makes sense because acetylcholinesterase activity is generally high only during the early stage of Alzheimer's disease (acetylcholinesterases are enzymes which breakdown acetylcholine--a compound critical for short-term memory).  In any case, these drugs such as Aricept and Exelon do not appear to change the progression of the disease.  


 

Namenda/memantine is prescribed for moderate to late stage Alzheimer's disease.  It inhibits the influx of calcium limiting the death of neurons but not very effectively.   


Lane Simonian
Posted: Thursday, October 3, 2013 5:24 PM
Joined: 12/12/2011
Posts: 4586


This is perhaps one of the most sterling defenses for Medicare's decision not to provide coverage for brain imaging.

 

Long Island, NY - October 3rd, 2013 - Mary Ann Malack-Ragona, Executive Director/Chief Executive Officer, Alzheimer’s Disease Resource Center, Inc. (ADRC), says those who are seeking services for their loved ones suffering from Alzheimer’s Disease will still have access to those much-needed services, despite a recent ruling on brain amyloid imaging and national reports.

In a recent email sent from Harry Johns of the Alzheimer’s Association, he tells constituents that, as a result of the Centers for Medicare and Medicaid Services’ (CMS) decision, “Without coverage of recent scientific innovations like brain amyloid imaging, most of these individuals and families will be unable to access resources they truly need.”

Ms. Malack-Ragona says that Alzheimer’s patients do not have to rely on imaging or other more expensive diagnostic testing to secure resources. “While imaging provides a more positive and often conclusive test result, the truth is, physicians are providing accurate diagnoses that enable us to secure resources and services for our clients,” she says. “We can get a diagnosis of AD with a minimum of a 95% accuracy rate and, since 1993, no one has ever turned away any of our clients when I’ve reached out for assistance because imaging wasn’t used to determine a diagnosis.”

“Since the CMS is willing to cover brain amyloid imaging under the “coverage with evidence development” policy, that gives us what we need to ensure an accurate diagnosis in difficult cases,” Ms. Ragona further states.

She also disputes Mr. Johns’ claims that the CMS’ decision will also affect patients’ access to “appropriate treatments.” “I’m not sure what ‘appropriate treatments’ Mr. Johns is referring to since we’ve failed to produce any new pharmacological interventions that will slow down or cure AD,” she says. “Based on what we are seeing at ADRC, most of the medications being used to address behavioral issues are causing more issues than the disease process. That is why we’re focused on behavioral interventions. The drugs currently on the market are used to treat the symptoms of AD — but, unfortunately, they do not always work and, in some cases, cannot even be tolerated by the person with AD.”

http://www.longisland.com/news/10-03-13/mary-ann-malack-ragona-comments-on-centers-for-medicare-and-medicaid-services-decision-for-brain-amyloid-imaging.html

The acetylcholinesterase inhibitors, Namenda, anti-pyschotic, anti-anxiety, anti-depressant drugs used for Alzheimer's disease often did more harm than good.  The medical community should have and could have done much better.  Maybe some day, they will 


The1&onlygirl
Posted: Monday, October 7, 2013 10:45 AM
Joined: 5/13/2013
Posts: 315


Thank you Lane for your post and for making such a good case. 

 

More reason to do a more thorough investigation of non-pharmaceutical treatments and save the gov't some Medicare $$$, because we all know there are few of those $$ left.



Lane Simonian
Posted: Thursday, October 10, 2013 10:58 AM
Joined: 12/12/2011
Posts: 4586


Thank you, The1&onlygirl!  Thank you for continuing to help and support us who are still here.  And I am glad that there are others here who can help you through the days ahead.
Mimi S.
Posted: Thursday, October 10, 2013 1:49 PM
Joined: 11/29/2011
Posts: 7035


My thoughts: The evaluation tool was the Mini Mental Exam. Knowledgeable folks know its pitfalls. The higher the intelligence, the worse it's value as a predictor. And its use for people who are not tested using their first language should always be evaluated.  If it should not be used for diagnosis, why should testing of a few areas of cognition be used as a measure of improvement or lack thereof?

Just as there are stages of dementia, there are stages of MCI.

 

 Although most diagnosticians feel their method is scientific, as I listen to people relating their own perceived problems, the testing used and final diagnosis arrived at, I feel the results have a lot of personal judgement involved. 

It may be that medications at the very earliest stages are ineffective, but I personally feel that for most people as they approach that wavy line that distinguished MCI from AD or other dementias medications in the Aricept field are needed. Namenda and such, designed for mid stage can wait. 

Merely my opinion.