A farewell to Aricept

Just before I was diagnosed with Alzheimer’s last June, a doctor prescribed Donepezil, better known by its brand name, Aricept. I was already taking Strattera, a drug said to boost concentration, but in my case made me jumpy. To complete my trio of medications, the doctor prescribed the anti-depressant Zoloft. This last prescription was a mystery to me, since I was not depressed. Later I learned that the dosage was very low, perhaps negligible.

Soon I was only taking Aricept. But even at the modest level of 10 milligrams, the drug produced unpleasant effects. One was joint pain, and soon after I began taking the medication, an arthritic joint in my lower back, like clockwork, began to pain me early each afternoon, about fourteen hours after I had taken the pill. Other consequences were more dramatic. One night, when we were staying in a cabin in Vermont, I woke up feeling as if I had stepped into a factory at full capacity, with ear-splitting noise and bright lights. I was hesitant to journey down the steep flight of well-worn wooden stairs to get a glass of water, and I needed about a half-hour in the kitchen before I was ready to resume my sleep. Worst of all, one morning I got a foretaste of why Cialis and Viagra make explicit disclaimers about their drugs’ side effects. What Aricept produced was not a pleasurable sensation.

In consultation with my doctor, I reduced my dosage to just 5 milligrams. And while the side effects went away, so did, perhaps, all traces of its efficacy. I took this low dose for a week, and then I would go another week with no Aricept at all. It was hard to tease out whether there was any benefit at the lower level.

At the recommendation of a friend, I reached out to Robert Whitaker, a prominent critic of the biopharmaceutical industry. Whitaker, who is based in Cambridge, is the author of several books, including Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. In an email, Whitaker made clear that he is not an expert on Aricept’s possible consequences. But he did offer a powerful anecdote: His father, who was in an early stage of Alzheimer’s, experienced a psychotic reaction after taking Aricept.

 “It sent him into a tailspin from which he never fully recovered,” Whitaker said. And when he looked into the drug’s properties, he learned that the labeling, at that time, made clear that the medication was not intended for people with mild or early-stage Alzheimer’s.

Whitaker suggested that I look into Aricept’s possible side effects today, and the list is long and disturbing: weight loss, dizziness, depression, confusion, hallucinations, among others. There are plenty of reasons for me to leave my Aricept tablets inside their bottle. Or, better yet, dropped into the drug-disposal box at my local police station.