Public Coverage of Donepezil Achieved in Two Provinces

Eleanor Brownridge

Until recently, many general practitioners have been hesitant to diagnose Alzheimer's Disease (AD), especially at the mild and moderate stages. They believe that patients and their families don't want to hear this bad news and therefore don't push the issue.

"We have to work hard to change the attitudes of physicians," says Dr. Ron Keren, geriatric psychiatrist with the University Health Network, Toronto General Hospital. "We have to move away from stigmatizing Alzheimer's and start approaching it as any other serious disease. We need to talk frankly, openly and honestly with our patients." Research from the United States has shown that 80 percent of seniors want to know if they have dementia. Dr. Keren, who also practices at the Toronto Rehabilitation Institute and the Whitby Health Centre, says that in over seven years he has never had a patient who didn't want to know the state of his disease. "If you can't talk about it, how can you treat it?"

With the recent decisions of Ontario and Manitoba to reimburse donepezil (Aricept) in those provinces, physicians now have a treatment for mild to moderate dementia of the Alzheimer's type that can bring hope to all patients and their families, not just those who can afford it.

Donepezil inhibits the activity of acetylcholinesterase, thereby increasing levels of acetylcholine in the brain.