My husband has lewy body dementia. he is on aricept 23 and namenda for many years. the new doctor advises trying exelon (rivastigmine). i am afraid to change. is one better than the other?

Lew body dementia: I would have a preference for the Exelon (rivastigmine) patch which has the indication for parkinson's dementia.

Perhaps: The fda has approved Exelon (rivastigmine) for use in parkinsonian dementia, which is very similar to "lewy body dementia", and the difference is very subtle. Aricept has never shown significant benefit consistently in research studies on lewy body and is not my preferred agent either. Namenda has shown poor results for the most part also. Would definitely heed your doc's advice.

Try it: This is a tough condition. I have seen only a couple cases. The time for making change comes sooner than later. I bet your doctor understands. Sometimes one drug will work better than the other. I think he means adding Exelon (rivastigmine) or substituting it for aricept. Be sure which is the plan. Namenda might be kept on board. You can always go back to what combo worked best.

Probably not: There is little reason to think one cholinesterase inhibitor (aricept, exelon, (rivastigmine) reminyl) is better than another at this point in our knowledge base. There is a small chance this change could help a little and a small chance this change could make things worse. I would ask his doctor why he was suggesting the change because there may be a specific reason that the suggestion was made.