Q: I am an 86-year-old female. I have started taking Namenda two times a day. The doctor says I have extremely mild dementia and it is only to maintain my current mental status. I’m very tired and have gained 10 pounds but am still gaining. This weight seems to be going directly to my stomach. I am small framed and 10 pounds is making me quite uncomfortable. I also take 5 mg Norvasc, 40 mg pantoprazole and 2 mg of clonazepam on a daily basis. Do you think this weight gain will stop or am I stuck with this discomfort?
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A: As a general rule, Namenda is prescribed to treat moderate to severe dementia such as is seen with Alzheimer’s but it may be used for other purposes, as well. The recommended starting dosing is 5 mg a day and advancing to 20 mg which you are on. Side effects can include confusion, hallucinations, fainting, easy bruising, difficulties concentrating, elevated blood pressure readings and more. Less serious side effects noted include fatigue, and weight loss (not gain) from having a diminished appetite.
Norvasc is a calcium channel blocker that treats high blood pressure, angina and other conditions caused by coronary artery disease. Side effects can include edema of the extremities, chest flutter, and less commonly fatigue, abdominal pain, headache and a drowsy feeling.
Pantoprazole decreases esophagitis and other conditions caused by excess stomach acid production. Side effects can include a rapid heart rate, muscle cramps, headache, memory problems, loss of appetite, fainting, hallucinations, insomnia and weight changes.
Clonazepam is prescribed to treat symptoms of anxiety or panic, seizure disorders, and other purposes. This drug is produced in doses as small as 0.125 and as strong as 2 mg. Initial dosing should not exceed 1.5 mg per day, divided into three doses; however, to reduce the effect of drowsiness, this drug may be ordered as one dose at bedtime. Side effects can include fatigue, loss of appetite, diarrhea/constipation, confusion, pounding heartbeats and weight changes.
So, as you can see, except for your Namenda, the balance of your medications can produce relatively similar side effects but are not likely linked with your weight gain. Further, if you admit to being tired, I wonder if you are less active than you once were, are more sedentary sitting to watch television or reading, and if you may be retaining fluids. As such, I recommend you speak with your prescribing physician to determine if you can reduce the dosing on any or your meds (one at a time) under his or her direction and can simultaneously initiate a plan of exercise. I’m not referring to working out on an elliptical machine but you might begin by joining a friend for a walk around the block once or twice a day. If you’re not a walker, consider other activity you might have enjoyed a few years ago and, if appropriate and again, only with your doctor’s approval, initiate it once more. Reduce your consumption of sodium (salt) in your daily diet by reading labels when you shop. As an example, the ingredients in processed foods may contribute to your high blood pressure. Modifications may allow you to reduce or eliminate one of your medications. Then request a referral to a dietitian for direction on what foods would help you lose your 10 pounds and ultimately maintain a desired weight. You shouldn’t have to be “stuck with the discomfort” of weight gain.
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