A patient who has Alzheimer's disease has been taking donepezil for 1 year. The patient's spouse reports a worsening of symptoms. The primary care NP should consider:
a. switching to ginkgo biloba.
b. adding an antidepressant medication.
c. changing to galantamine (Razadyne).
d. adding memantine hydrochloride (Namenda).
D
Memantine hydrochloride can be added to therapy when symptoms worsen. Ginkgo biloba may be useful but is not recommended as adjunct therapy. Antidepressants given to patients with Alzheimer's disease who have depression appear not to be effective and often cause adverse effects or produce unwanted drug interactions. Galantamine is part of first-line therapy but should not be given with donepezil because both are ChE inhibitors.
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