My mom has been on Aricept (and Namenda) for nearly three years. She has dysphagia (swallowing disorder), so I have to crush her pills so that she can take them. Because of the dysphagia, she shouldn't take regular Aricept, which shouldn't be split or crushed, so her doctor prescribed Aricept ODT, which dissolves on the tongue. The instructions say that she's supposed to leave the tablet on her tongue until it dissolves, swallow several times, and then drink a glass of water.

Last night was the first time I gave her one of the ODT tabs. I asked her to let it just sit on her tongue. She said OK, then started to chew it. Then she swallowed it and drank some water. I held my breath, terrified she might choke, but she didn't, thankfully.

She really doesn't grasp the concept of taking pills, let alone how to take them, which was something that worried me before I even gave it to her.

Why in the world would a drug manufacturer make a pill for people who are cognitively impaired and have a swallowing disorder and expect that they'll understand that they're not to chew or swallow it whole but let it dissolve?

I don't know that Aricept is even of much benefit at this point, but it does seem to help her sleep. When she was off it for a brief period last year, she woke more frequently at night and didn't rest as well.

Has anyone had a similar experience, and if so, do you have any suggestions?

Mom was on the pill very early into the disease and we never saw any improvement and still saw rapid deterioration, so we stopped that and went to something else.

I am just as amazed as you are about the form this drug comes in for people who have a disease that has swallowing disorder as a normal part of it! Why on earth? I know that it is not likely for you to be able to get her to keep the tab on her tongue long enough for it to dissolve - the natural thing for her to do is chew it, of course. And what's with the added steps?

They need to stop with the dissolvable tabs and move on to a syrup.

One idea - Razadyne is similar to Aricept (our neurologist said they are interchangeable). Razadyne comes in liquid form:

http://www.empr.com/central-nervous-sys ... drug/4109/

Hey Grits, I know very early on my grandmother gave my grandfather difficulty with swallowing, so he crushed her pills and put them in applesauce, which is a method he still uses. I think it does cause Aricept to lose its effectiveness a bit, but I don't think that it's dangerous. Nevertheless, if you feel that at this stage the Aricept isn't doing much, which it has been shown to not be effective in late stages, then you can simply ask the physician for something to help her sleep at night to substitute for the Aricept (if this was an effect you noticed it had on her). My grandmother takes lorazepam now and sleeps very well all through the night. Without it she is utterly agitated all night.

My late husband was given liquid Namenda. He passed away in Jan of this year from AD. The liquid Namenda was was very easy to give. Good luck & God bless you and your Mom. Karen

Judy, I had not heard of Razadyne; a liquid would be marvelous. Thanks for the link.

Aitan, I had been thinking about asking Mom's doctor if there was something else she could take at night if we discontinue the Aricept. That's good to know that lorazepam is helpful for your grandmother. I always appreciate your input as both a medical professional and a family member of a LO with AD.

Karen, thank you for the information about Namenda. I'm so sorry about your husband.

I will be calling Mom's doctor today and will mention all these things to him to see what he thinks would be best for her.

Thank you all for your suggestions. I really appreciate them.