Alan's researcher stated: "The drop off in aricept is variable and not
seen in everyone but can > happen... there is a clinical impression
that some things lost in the drop

Mary responds:
Alan, having watched AD dismantle my MIL neuron by neuron, and
corresponded with hundreds of families going down the same road as part
of my volunteer work with allexperts.com (I answer AD questions), I'd
say...this guy is...minimizing bigtime. He's not living with her. He
hasn't been married to her, doesn't rely on her, love her, need her,
want her.

No matter how rational a man you are, no matter how educated, no matter
how carefully you research, you cannot fully prepare yourself for what
is ahead. AD cuts to the heart of our most deeply held assumptions and
beliefs about human personality, emotions, motivation, abilities. There
are few of us who don't have our fundamental assumptions about the way
the world works rocked by AD - the idea that people have control of
themselves, are accountable for their actions, can see how their
behaviour impacts others, have insight into their own situations and
problems. We also make huge assumptions about abilities based on our
own intact brains - we reason, okay Task A is much less complex and
demanding than Task B, so if they can do B, they should be able to do A
- and then we are totally at sea when we discover we're wrong. We don't
"get" that being able to do what seems like even a simple thing like
taking a bath requires an intact web of interlocked abilities. If one
piece is missing, the whole thing falls apart.

Right now, I know you see a wife who is still herself in terms of
personality, and other than some forgetfulness, your working
assumptions about her are unchanged. That is a kind of heaven you are
about to lose - and don't think I exaggerate. You will shortly have to
continually question and reassess every aspect of her abilities, her
actions, your relationship - what needs supervision and what does not,
what you can allow and what you have to forbid, what you let yourself
to relax about and what you have to worry and think about - that you
never thought about or questioned before. AD is also very unpredictable
and fluctuates - so as things move along in the illness, you will never
know from one day to the next what to expect or rely on.

your spouse is no longer herself and the ground goes out from under you
(as it will) is something worth doing. I'd be very hesitant to stop a
drug that is preserving function, even if you can't SEE that its
helping.

What the doctor thinks are minor things in his impersonal big picture
view of Alzheimer's decline may seem huge losses to you - like her
ability to read a calendar, tell time, make change, make a grocery
list, bake a cake, work appliances. He thinks in terms of chunks - like
being able to dress herself or not, toilet or not, feed herself or not
- not in terms of the tiny everyday things of life that make the
difference in your quality of life together, and that will take the
role of spouse/partner from you.

My 2 cents, anyway.

M

There is a 33% chance (from the data they publish) that your wife will get a
medically relevant dose of Flurizan. You'll have to trade that against the
odds she'll lose a year, or two, or three, of abilities, eg she'll
fast-forward to where she would be in that many years time. (This is if the
trial is as before, eg placebo, 400mg and 800mg)

That has to be traded against whatever benefit Flourizan will provide, which
I'm sure you can assess for yourself from the literature. Its a tough call,
if it was me I wouldnt do *now* but might hope to be able to get on it in
say a years time, but I can see why someone might also think its worth
taking the risk.

I'd also consider instead of the trial, if its possible, adding memantine ,
from what I read and what people say here, memantine and aricept together
work pretty well.

once again:  if it were my spouse i wouldn't take the chance by
taking her off a drug well known to slow down AD's progress in
order to have a 50% or less chance of her getting the new drug.

God, what a tough question.

My mom is now in a nursing home due to AD.  Aricept does not cure. no other
way to put it.  It may slow down the AD, but alzheimers will still win.  I
am trying my best to get her into the Flurizan trial, but they dont want
anyone in a home for at least 6 months.  Flurizan is being flaunted as
attacking the cause.... not the symptom.  As cruel as this may sound, but
not meaning anything bad by it at all, I dont want my mother just to
"last" - I want her well.  I personally would take any risk(s) for myself to
see to it that I dont whither away in a home where they really dont care
about me other than making my final days comfortable.
To hell with that!  if it hurts to make me well, then knock me for a loop to
get it done.  And I know that my mother would have the same opinion as me.
Who wants to be a vegetable and live forever?

good luck.  I know it is so easy to be overun with opinions and emotions,
but after you clear you head of emotions, do what you think is best.  No
other person cares about you or you wife near as much as you.