Cognitive Medications

[JohnBaden]

My Neurologist has suggested that I should take medication for my cognitive symptoms. One suggestion is to take Aricept. There were others too. If you can could you advise me as to your opinions over 'Cognitive' medications. Aricept is one but I know there are others. Please let me know your views/knowledge. Thank you. John.

[twisterred]

Aricept allows for more blood to the brain,which helps with memory (what my neuro told me).
I took it for a while, but a side effect from allowing more blood to the brain is headaches (for some).
I stopped taking it because the headaches were too much.
So for me, thumbs down to Aricept.

If you are NOT taking an interferon drug, and not allergic to opium meds, LDN can be helpful with memory. It removes much of that brain fog MS gives patients have.
There truly is a benefit with the drug regarding memory for me, so I give LDN a thumbs up.

I asked me doc is Alzheimer's and MS fog were the same and he assured me they are not.

[hunterd]

hey john,
evening primrose oil helps combat cognitive issues. a dr at cleveland clinic mellon center told me that. good luck.

dave

[wkikta]

Studies have shown that Aricept and other Alzheimer's medication don't do much for MS memory problems since they tend to be different parts of the brain.

[Redwings]

Aricept allows for more blood to the brain,which helps with memory (what my neuro told me).

It's interesting that a neurologist would say that, because that's not how Aricept is believed to work. Aricept is an acetylcholinesterase inhibitor (AChEI), which works by affecting a neurotransmitter, not blood flow. This looks like yet another entry for my list of Things That Doctors Say To Patients Because They're Easy To Understand Even Though They Aren't Entirely True.

John, as has been pointed out, there really aren't any stand-out medications for MS-related memory and cognitive problems. Even the researchers for a small study of Aricept (donepezil) that showed promise later felt that the potential wasn't as promising as it first seemed. Still, you might try it for awhile and see how you do on it.

Here are links to some abstracts about AChEI and MS studies:

Treatment of cognitive impairment in multiple sclerosis: is the use of acetylcholinesterase inhibitors a viable option?
http://www.ncbi.nlm.nih.gov/pubmed/18193921

Are there protective treatments for cognitive decline in MS?
http://www.ncbi.nlm.nih.gov/pubmed/16643949

Effects of donepezil on memory and cognition in multiple sclerosis.
http://www.ncbi.nlm.nih.gov/pubmed/16626752

Donepezil improved memory in multiple sclerosis in a randomized clinical trial.
http://www.ncbi.nlm.nih.gov/pubmed/15534239

A 12-week, open trial of donepezil hydrochloride in patients with multiple sclerosis and associated cognitive impairments.
http://www.ncbi.nlm.nih.gov/pubmed/10831023

Another drug, memantine, has also been studied for MS cognitive impairment. It's been awhile since I read the abstracts so I'm not fresh on the details, so anyone interested should google this for themselves. In a nutshell, memantine showed a small benefit in one trial, but in another, subjects reported that their functioning was actually worse. A third trial was stopped because the subjects were doing so much worse on memantine that it was pointless to continue.

Fampridine (4-AP) and LDN are other options to try.

[twisterred]

It's interesting that a neurologist would say that, because that's not how Aricept is believed to work. Aricept is an acetylcholinesterase inhibitor (AChEI), which works by affecting a neurotransmitter, not blood flow. This looks like yet another entry for my list of Things That Doctors Say To Patients Because They're Easy To Understand Even Though They Aren't Entirely True.

Redwings, thank you so much for explaining I was wrong!
Wow... if this doc hadn't retired already, I'd be super bothered at my next appt.

Thanks again for explaining how Aricept works.