Mailbox Response

The question was submitted Thursday, 23 April 2009

Subject: FTD

My hubby has been diagonised with FTD he is 57. They have put him on Aricept 10mg which has helped with his speech, however he gets severe "cramps" to the point where he has to shower at least 4-6 times a night as this seems to be the only thng that helps, it is early days for our journey, I know,but would like to know if the severe "cramps" as he calls them are part of his illness, heave read that FTD can cause rigidity and he has lost a lot of wieght, although our Dr says he physically fit and loss of wieght is part of the disease....?

Answer from DementiaNet

This is a tricky situation.

The cholinesterase inhibitor class of drugs which include Aricept  do not have a government endorsed indication for FTD. This means technically if they are prescribed by a doctor the government will not subsidise the cost which is very expensive.

One of the reasons for this is that there is no good data of their efficacy in FTD and there is a lot of anecdotal data to say it may even aggravate (whilst still on the drug) the patient’s condition.

In the case of your husband he has actually benefited from the Aricept.

As for cramps, these are an uncommon but well recognised complication of this class of drugs. My guess is they only started after he commenced the Aricept.

In which case, you have to weigh up the pros and cons of staying on  Aricept.

From your description, I would advise stopping Aricept for four weeks and see what happens to his FTD and to his cramps. If the cramps persist you  know it is not the Aricept.

If the cramps do go away and he deteriorates mentally , then it may be worth discussing with your doctor switching to another drug such as Reminyl or Exelon patch and hope that the cramps do not recur.

The answer was published on DementiaNet Tuesday, 28 April 2009