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Treatment for Early Stage Alzheimer’s: What is the Patch?

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excelonPatch

When you hear about treatment for early stage Alzheimer’s,  there are always questions about the patch.  Several years ago, the FDA approved the Excelon Alzheimer’s Patch for use in reducing dementia symptoms associated with Alzheimer’s disease and Parkinson’s disease. The active ingredient in this patch is rivastigmine (trade name Excelon), a cholinergic agent that can also be given orally in capsule form. However, researchers have discovered that many side effects caused by the oral application of rivastigmine are eliminated when administered in patch form.

What is Rivastigmine?

Available since 1997, rivastigmine is classified as a cholinesterase inhibitor that works to suppress mild or moderate dementia symptoms by preventing cholinesterase enzymes present in the brains of AD and Parkinson’s patients from breaking down an essential chemical called acetylcholine.

A neurotransmitter involved with regulating motor functioning, cognitive processes and blood pressure, ACh is contained in cholinergic neurons that are found in the spinal cord and in many areas of the brain. When ACh is released by a brain cell, the chemical quickly locates another neuron with receptors specifically designed to utilize this neurotransmitter in passing signals onto other cells. When ACh cannot be released or cannot access appropriate receptors, brain functioning can be seriously inhibited.

Treatment for early stage Alzheimer's

Alzheimer’s dementia, with its choking plaques and tangles infiltrating parts of the brain, damages these cholinergic neurons and prevents them from releasing ACh. Patients suffering from AD experience cholinergic neuronal death especially in the amygdala, cortex and a region called the nucleus basalis of Maynert situated in the basal forebrain. Because of decreased amounts of ACh facilitating neuronal signaling, symptoms such as impaired motor functioning and reasoning abilities will severely affect patients with dementia.

More on the treatment for the early stage of Alzheimer’s …

Description of the Alzheimer’s Patch

This new form of treatment for Alzheimer’s disease is a small transdermal patch applied once a day (at any time) and consisting of four layers:

  • The innermost layer, layer four, is the release liner, which is removed before applying the patch
  • Layer number three is an adhesive
  • Layer number two contains the medicine
  • Layer number one is a colored backing that holds the patch together

Over a 24-hour period, the Excelon patch delivers a continual, safe amount of rivastigmine into the bloodstream of the dementia patient. According to the official website Excelon Patch, the efficiency and amount of the medication may vary depending on where the patch is placed.

A study conducted regarding the efficacy of the patch when applied to the chest, thigh, upper arm, upper back and abdomen revealed that adhering the patch to the chest, upper arm or upper back facilitated a better release of the drug.

As an convenient and safe treatment for early stage of Alzheimer’s, the Alzheimer’s patch cannot “cure” AD but it may help significantly slow the development of the disease, if used during the mild to moderate stage of AD or Parkinson’s disease.

Side Effects of This Alzheimer’s Medicine

Patients often experience nausea and vomiting when using rivastigmine in oral form because of its powerful ability to inhibit the destructive activity of cholinesterase enzymes. However, people using the Excelon patch suffer rates of vomiting and nausea at significantly lower levels. Any side effects experienced by Excelon patch wearers are usually mild and subside in time, such as occasional itching or redness around the patch site.

Rivastigmine is eliminated by the body through urine output, bypassing the gastrointestinal tract and the liver comprising the hepatic system. Because certain enzymes are not involved in the drug’s expulsion from the body, it has a very low potential for negatively interacting with other drugs that are used in the treatment for early stage Alzheimer’s the patient may need to take.

alzheimer's treatment

Signs that the Alzheimer’s Patch is Working

  •  Noticeable improvements with the ability to recognize, recall and communicate
  • Tasks requiring concentration were completed 20 seconds faster when compared to people who were taking placebos
  • If symptoms remain the same instead of worsening. (AD is a progressive disease that never improves but steadily deteriorates the cognitive abilities of affected individuals)
  • Caregivers readily detect sharper thinking, less depression or anxiety and more motivation from someone responding well to the patch
  • Caregivers should not look for discernible improvements in someone with AD until eight or nine weeks have elapsed

More on the treatment for early stage Alzheimer’s : Comparing Alzheimer’s Disease Treatment Plans

 When treating mild to moderate dementia, the Excelon patch is one of most effective treatment options available. Most patients respond well to the medication and find the patch to be more convenient to use than capsules, since many elderly people have trouble swallowing oral medications. A drug called donepezil (trade name Aricept) that has been approved by the FDA to treat all stages of Alzheimer’s dementia and is often prescribed for patients suffering signs of advanced dementia.

In addition, the Alzheimer’s patch does not need to be removed when bathing or swimming, making it even easier for caregivers to assist AD patients in performing daily hygiene practices. More information about how to properly use the patch and what to do if adhering the patch to a patient’s skin is problematic can be found at Excelon Patch.

 

 

caregiver stress cd pic

Sources

http://psychcentral.com/news/2006/07/21/the-patch-for-alzheimers-disease/115.html

http://www.touchpsychiatry.com/articles/review-first-transdermal-treatment-alzheimer-s-disease-rivastigmine-patch

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761169/

http://www.exelon.co.nz/index.html

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