Q. My 82-year-old mother has had Alzheimer’s for eight years. She sat all day and didn’t feed or bathe herself. Although she smiled pleasantly, she couldn’t retain working memory for more than two minutes. She repeated statements or questions over and over.

Last month she fell and broke two ribs. Her doctor put her on a narcotic pain reliever, hydrocodone (5 mg twice daily). A few days later she “woke up.”

She is talking, laughing and feeling quite sad to hear she has Alzheimer’s and that her close friend died three months ago. She is now dressing herself and putting on make-up for the first time in years. She told my sister, “What have you been doing to my hair? This is terrible and too light! I need a hair appointment tomorrow!”

Yesterday she opened up her phone directory and called three friends. She even supervised cooking dinner, though she hasn’t cooked for years. Have you ever heard of hydrocodone acting like this for Alzheimer’s disease?

A. What an amazing story! We could not locate any research testing narcotics such as hydrocodone for Alzheimer’s disease.

We heard a similar anecdote, however. A woman in the final stages of Alzheimer’s disease was put on Oxycontin (oxycodone) for pain relief her last two weeks of life. During that time she was lucid and capable of communicating for the first time in months.

A few weeks later we got this message from another reader:

Q. I read the letter about a reversal of symptoms in an Alzheimer’s patient who was put on the pain reliever hydrocodone. My dad is a 90-year-old Alzheimer’s patient in an assisted living facility. I myself am a pharmacist, and I felt compelled to write to you.

About two years ago my father fell and broke his hip. He was taken to the emergency room and given a shot of the narcotic Demerol to control the pain. When I got there, expecting him to be even more confused than usual, he was absolutely lucid and answered all the ER doctor’s questions accurately.

My sister and I were flabbergasted and figured his clarity would end when they took him to surgery, but he came out of surgery quite lucid, like his old self. This lasted several days but slowly he regressed back to his forgetful Alzheimer’s self.

As a pharmacist, I tried to make sense of it. I discounted the Demerol and thought it must have been a physiological reaction to adrenaline. I told everyone about it–his neurologist, internist, orthopedist, other physicians, fellow pharmacists, drug reps, researchers at meetings–but no one had any explanation and we all thought it was a fluke.

Six months later my father fell and broke the other hip. Bingo. Once again he was lucid and like his old self after being put on an analgesic, but then slowly regressed.

Your column is the first time I have ever seen any mention of this phenomenon linked to narcotic pain relievers. I would love to get to the bottom of this for both personal and professional satisfaction.

A. Yours is the fourth such amazing anecdote we have encountered. In each case, when an Alzheimer’s patient was given a narcotic analgesic, there was a significant, though temporary, improvement in the condition.

We have consulted some of the country’s leading experts on Alzheimer’s disease and they have no explanation. Although this may be a coincidence, we think it is so interesting that it ought to be studied scientifically.

Sadly, we have not discovered any research into these fascinating reports. Experts in the field discount the stories or just seem uninterested in following up. What a shame. It seems as if such anomalies deserve further study, even if the effect is temporary.

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  1. BS
    PA
    Reply

    When my 88 year old mom with dementia had a burst fracture at L1 and was put on Dilaudid, her memory, mood and sleep improved drastically. It was wonderful to see her old self emerge. She was playing games, and laughing. Her doctor is trying to take her off Dilaudid, so we have reduced the quantity from 5 pills a day to 1/2 pill every 8 hours with Tylenol. It has been over 2 weeks now, and we see a drastic decline in her short term memory. She is not sleeping well and is getting days and nights mixed up.

    When she has a UTI, she shows no pain symptoms, and I think it is the same with her advanced arthritis and osteoporosis. When her pain is controlled her quality of life drastically improves. I don’t see any reason why a very elderly patient can’t have opioids indefinitely if it improves their quality of life.

  2. Judi
    Pleasanton
    Reply

    Agree. My father had some memory problems but was still working at 72! Two years ago he fell in the shower sustaining 3rd degree burns on 6% and 2 dgree burns on 24% of his lower body. He was in the hospital for weeks where he recieved around the clock pain medicine. He came out of the hospital with an opiate rx and unable to recognize his grand children. A couple months later he’s having his diaper changed by homecare :( I HAVE NO DOUBT that the opiates exacerbated the disease. Please check with the octor before giving your loved one “Aunt Millie’s” gout meds.

  3. Becky
    South carolina
    Reply

    My 83 year old husband diagnosed 8 years ago with dementia, had some oral surgery roads, he was given a prescription for oxycodone. We have had the loveliest evening, he is smiling, helping me with Christmas decorations. I was compelled to go to the Internet and now I see that it is a phenomenon.

  4. Yana
    Bellingham
    Reply

    My Dad is currently in the hospital with a broken rib – while he was on a lower dose of pain meds the first day after the break – he actually did seem far more with it. He knew my sister was visiting (which he forgets everything really a few seconds after he learns it now), and that he and Mom had been a hotel for awhile (their house is being renovated), he could understand me and follow what I was saying. He understood that he had a broken rib and that he was at the hospital. However, his pain progressed rapidly from different needs to move him in the bed, and he developed a wheeze and was asked to cough, which hurt – so his meds were upped – and the benefit was gone and delirium set in. But I was thinking – hey, does anyone know a little bit of narcotic might actually REVERSE Alzheimer’s? At least a little.

  5. Linda
    PA USA
    Reply

    My mother who is 90 also has been suffering from dementia. Her neck pain was so severe (from degenerative issues) at one point that we had to move to Oxycodone for relief. Within just 20 minutes of taking only 1/2 pill she was almost her normal self without dementia. It happens every time. We can actually see the change happening. Why don’t they do a study on this? It seems it is very similar to some mentally ill who have to take pills to be able to function normally so how are those with dementia different?

  6. Vv
    Arizona
    Reply

    IHave been taking. Oxycodone for a few years maybe like 3 years for seveare back pain because I have stomps and scoliosis kyphosies on my back and I can not stand the pain but I have been very concern about my lover and also sometimes I worry that I might get deminta or ALeihmers from take so many pain pills I only take them once a day but sometimes.

  7. Kitty
    IL
    Reply

    My mom is 93 and has dementia. She is in a memory care unit in a nursing home. She had been taking 5/500 hydrocodone for a few years. When she went to the nursing home, they took her off hydrocodone & put her on tramadol, which did nothing for pain. long story short, I convinced the doctor to put her back on hydrocodone, which now has been about 6 wks. I definetly see a difference in her memory, etc. She has been calling more people on her cell phone and just seems to be more alert to whats going on. But, she has become very agitated lately, wanting to fight the other residents etc! I’m really hoping she has a UTI and it is not a side effect to the hydrocodone.

  8. cc
    Virginia
    Reply

    Please put me on the list to receive notifications about this topic.

  9. Letitia
    California
    Reply

    Opiate drugs do not always help cognition in the elderly! Sometimes they can cause symptoms that mimic Alzheimer’s Disease.
    My mother had been using Hydrocodone (Vicodin) for many years for the pain from disintegrating back vertebrae. She didn’t have any cognitive or other problems (except constipation) from that drug, but around the time she turned 80, I was worried about the (then) significant amount of acetaminophen she was getting (while taking up to four of these pills a day) and its impact on her liver. So her doctor prescribed Oxycontin (while she still had some Vicodin tablets left).
    Soon after getting the prescription for Oxycontin, she suddenly couldn’t understand what I was saying to her, and suddenly made no sense herself. I thought she’d had a stroke. My sister-in-law, a doctor, told me she’d been able to get me an immediate appointment at a good clinic — without telling me it specialized in Alzheimer’s Disease. My mother had had no symptoms of Alzheimer’s Disease before this (my sister-in-law doesn’t like my mother).
    Five doctors at this clinic (colleagues of my sister-in-law), after giving my mother an expansive battery of tests of all kinds, diagnosed her with “atypical Alzhiemer’s Disease.” However, they’d never looked at her history of precription drugs. I got it and noticed the suden onset of symptoms had come soon after the Oxycontin. Sure enough, once she stopped taking that the symptoms went away.
    Several years later, after a surgery, she was accidentally given Oycontin, and promptly hallucinated that she was in a dark forest while lying in a well-lit hospital room. The withdrew teh Oxycontin, and she returned to normal.
    I have read several anecdotes of similar side effects of Oxycontin, and several nurses have said, oh, yes, Oxycontin can be problematic for patients, especially elderly patients.

  10. Jewel
    Jacksonville, FL
    Reply

    For many months, my mother has been unable to remember what she had for lunch only 15 minutes earlier. She is often unable to remember the names of her children and grandchildren. When asked a question regarding the past, she states, “I don’t know that was too long ago.” However, since she has been in too much pain to participate in physical therapy, her doctor prescribed Lortab. When I arrived at the nursing home where she resides, I found a new mother. One who stated, “Well where did you come from?” She laughed, joked and sang familiar songs with the great grandchildren all day and into the night. Her sitter reported this morning that she talked about her childhood and siblings until late in the evening, not wanting to go to sleep. The sitter said she had never seen her so expressive and able to convey her thoughts as well. She told us of event which occurred over 90 years ago, when the day before, she was unable to name her uncle when asked. She enquired about several relatives we thought would have forgotten. One of her great granddaughters, smiled and stated, “Wow, I think Granny’s feeling better! She knows my name and that I like to ride horses!” Her family stood around the bed in amazement. I went to the nurses desk today ad asked if there had been a change of any kind in her medication and the only change was the addition of Lortab. Im so glad that I happened upon the article because now we know it’s not a fluke.

  11. Fan B.
    Savannah, GA
    Reply

    This is the first time I have heard about these stories. I, myself had a mother as an Alzeihmer’s disease patient for more than three years now. Two weeks ago she fell and hurt her left knees. My sister took her to the ER and the doctor prescribed her a 5 mg of hydrocodone. My sister gave it to my mom to take and she was sleeping all day. She went to she her primary doctor and he told her not to take it. If this narcotic drugs is working for some patients, I hope it would work the same to my mother. I’d like her to try for another 3-4 days to see if he Alzeihmer’s condition is improving. Thank you for the amazing story. God bless you all.

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