[sm25b]

Hi all!
I've come here to do some research of my own because I have come to a point in my life where I truly feel let down by so many doctors and specialists. About a year ago my mom suddenly, one day, said that her gynocologist was my brothers father (total different nationality, so its not even possible), that she felt the police had cameras set up to watch her, that there were helicopters flying over the house to get video of her... and she also started having conversations with the air and delusions that someone died (a different person every single day). She tried to jump out of the car when my dad was driving because she was adament that my son had died and she needed to get to his funeral. She has shown up at my house before with different items because I had asked for them (I hadn't).

I will say that she has never forgotten anybody's names, never forgets the date or her address... she does seem to have problems with short-term memory right now, but with the amount of meds she's on I don't know if this is a symptom of the meds or of her condition.

She had just turned 64 and is in otherwise good health. Before this all happened I started to have trouble communicating with her... although I attributed this to her having an auditory processing problem and severe dislexia. For a couple years she would start her sentences in the middle and I'd have no idea what she was talking about. For example, she'd say, "and then he called me back!". I'd ask who called her back and she'd get flustered.

We've been to 5 different psychiatrists who all say it's alzheimers and there's nothing they can do. She spent 10 days in a psych ward at the hospital where they said it was bipolar with mood disorder. Her primary care says that its mini-strokes and a neurologist says that she has some frontal vascular hardening... although it is normal for someone her age and didn't account for her strange behavior.

She's had bruising all over from holding and squeezing her arms and legs, she's lost 40 lbs (probably weighs about 115lbs.) because she believed my father was poisoning her, she actually handed me a baggy of poop once when my dad left the room so I could go get it "tested".

As of right now she is heavily medicated
- depakote
- risperdal
- lexapro
- arisept
?might be others

and she just sits there. She doesn't say a word. If you ask her a question she will answer with yes or no, but won't elaborate. At a football game someone asked her if she wanted a center or end piece of pizza and she litterely stuttered so bad about what she wanted that I was embarrassed for her (but didn't want to insult her by answering for her).

I haven't given up... I'm just going to take a different approach by doing my own research. I truly believe that it's something neurological... however I'm not sure what.

She has had MRI's, catscans, and EEG's... all inconclusive.

WHEW.... so that's why I'm here in a nutshell. There's tons and tons of more things that I could write about different things my mother has done, but I think that I've pretty much covered it.

If anyone has ever gone through anything similiar... has any suggestions... thinks they know what is wrong.... please im me.

Thanks

[Jomar]

That is a difficult situation.

It does sound a bit like a combination of things to me - mental problems {the paranoia, OCD, delusions}, maybe Alzheimer's also.
I think if strokes are suspected that should show up on some test.

I hope you can find better help and answers soon.

[Thelma]

Here is the new Dementia forum where you will find Michael 178who may be able to help you far better then I can. Good luck to you and your Mom.



http://neurotalk.psychcentral.com/sh...ad.php?t=27647

[GUMBY]

Your in N.Y.C.? Have you looked into anyone at Columbia or N.Y.U.? If you are close or have the means to get to someone at either,I would try there. I don't know if that is where you may have been. If you want to try there I could try to help you with a doc there. I wish you and your Mom the best. If you feel she needs to see a neurologist you do what you feel is best for your Mom. It sounds like your getting all different answers.

[DM]

Hi sm25~~ Wow, I really feel sad for what your Mom and your family are going thru. My MIL has Alzheimer's and some of what you said, could be applied to her actions. She has extreme Paranoia.

Hopefully, you can find some info here to help you deal w/the emotional as well as physical aspect of your Mother's illness.. Hang in there...

[polistem]

This has got to be incredibly frustrating for you and your mother. I just wanted to give you my warmest regards. Hang in there!

[MM's Mom]

my heart goes out to you. We went through something simliar with my dad about ten years ago (he was 74)...his diagnosis turned out to be Creutzfeld-Jakobs disease, but your mom surely doeesn't have that or she would be deterioriating much more rapidly and probably would show on MRI.

Anyway, I remember how difficult it was to deal with that paranoia. I wish your mom and your family the best. Keep us posted when you can.

[moose53]

There's a website where you can check interactions between the drugs that you're taking: http://www.drugs.com/drug_interactions.php

You should read this:

Interactions between your selected drugs

1. risperidone and divalproex sodium (Moderate Drug-Drug)

MONITOR: Coadministration with risperidone may alter the serum concentrations of valproic acid, although data are conflicting. The mechanism is unknown but may be related to risperidone displacement of valproate from plasma proteins. In one pediatric patient, serum valproate level rose from 143 mg/L to 191 mg/L five days following the addition of risperidone, necessitating a 43% dosage reduction of valproic acid. The level declined to 108 mg/L within 3 days and stabilized thereafter. In another patient, the addition of risperidone was associated with a drop in serum valproate level. The combination has also been associated with the development of edema in one patient. In contrast, a group of investigators found no difference in the mean valproate serum concentration-to-dose ratio (C/D) in 4 patients treated concomitantly with risperidone compared to that of 172 patients who did not receive risperidone. In two of the four patients, serum valproate concentrations measured on occasions when they were not taking risperidone also indicate no change in valproate C/D. Another group of investigators compared trough serum valproate levels in 45 patients, 29 of whom received concurrent treatment with atypical antipsychotics, and found no significant difference among those receiving divalproex with risperidone versus those receiving divalproex alone or with olanzapine.

MANAGEMENT: Until further data are available, clinicians may consider monitoring the pharmacologic response and serum valproate levels more closely whenever risperidone is added to or withdrawn from therapy. Ambulatory patients should be made aware of the possibility of additive central nervous system effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them.


*2. risperidone and donepezil (Moderate Drug-Drug)

GENERALLY AVOID: Due to opposing effects, agents that possess anticholinergic activity (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; class IA antiarrhythmics especially disopyramide; carbamazepine; cimetidine; ranitidine) may negate the already small pharmacologic benefits of acetylcholinesterase inhibitors in the treatment of dementia. These agents may also adversely affect elderly patients in general. Clinically significant mental status changes associated with anticholinergic agents can range from mild cognitive impairment to delirium, and patients with Alzheimer's disease and other dementia are especially sensitive.

MANAGEMENT: Drugs that possess anticholinergic activity should generally be avoided in patients with Alzheimer's disease or other cognitive impairment, regardless of whether they are receiving an acetylcholinesterase inhibitor. For patients requiring treatment for adverse effects of acetylcholinesterase inhibitor therapy (e.g., gastrointestinal intolerance, urinary problems), an agent without anticholinergic properties should be used whenever possible. Otherwise, a dosage reduction, slower titration, or even discontinuation of the acetylcholinesterase inhibitor should be considered. In patients who are already receiving an acetylcholinesterase inhibitor with anticholinergic agents, every attempt should be made to discontinue the latter or substitute them with less anticholinergic alternatives. Caution is required, however, since anticholinergic withdrawal may occur. Seizures have been reported following abrupt discontinuation of anticholinergics during acetylcholinesterase inhibitor therapy.


*3. risperidone and escitalopram (Moderate Drug-Drug)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.


*4. divalproex sodium and escitalopram (Moderate Drug-Drug)

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.


5. donepezil and escitalopram (Minor Drug-Drug)

Coadministration with inhibitors of CYP450 2D6 and/or 3A4 may increase the plasma concentrations of donepezil, which is primarily metabolized by these isoenzymes. In a 7-day crossover study in 18 healthy volunteers, the potent CYP450 3A4 inhibitor ketoconazole (200 mg once daily) increased the mean peak plasma concentration (Cmax) and systemic exposure (AUC) of donepezil (5 mg once daily) by approximately 36% each. The clinical relevance of these increases is unknown.

I'd be concerned about 2., 3., and 4. (above) given the behavior you're seeing in your Mom.

I'd sit down with your pharmacist and also with ALL of your Mom's doctors and discuss this. I've learned one thing in all my intereactions with doctors concerning drugs -- they don't know a darn thing about interactions. They just don't have the time to learn this stuff. That's why I always-always get the paper handout that comes with all meds and I always discuss any reactions first with my pharmacist.

When my Mom got sick (colorectal cancer), I had to go to South Carolina and authorize surgery and then move her here to Massachusetts. My Mom had never taken drugs, other than aspirin for headaches and a brief time with diet pills during the 50s. She was actually to the point where she was taking a knife to the nurses and conspiring with people to get her out of there.

Her blood gasses were off after the airplane flight. But, I think it was the drugs. The drug they used for the surgery caused a major depressive/suicidal reaction in me also.

I'd start with the drugs. It looks like you're going to have to figure this out for yourself.

Read this, too (the second one):
http://alzheimers.infopop.cc/eve/for.../171100662/p/2

I hope you can find what you need to make your Mom (and you) more comfortable. I know how hard it is to watch helplessly while they destroy your Mom's personality

Hugs.

Barb