Posted by Dr. Bob on April 17, 2001, at 10:37:38
In reply to Richelson: Geriatric drug combo?, posted by sixtieslibber on April 12, 2001, at 17:10:22
> My 88-yr old mother has had a variety of treatments for bipolar disorder with occasional psychosis for over 50 years. The last couple of years she's had a lot of ECT which stopped about a year ago. Now she's on Effexor XR, Wellbutrin SR, Mellaril, Seroquel, and Ativan. She's only been on the Seroquel a few months and her thought processes are a lot clearer. Her psychiatrist says he sees no dementia. She is very passive, mostly just sits. Also she can barely transfer from bed to wheelchair, etc. (Actually she has a lot of Parkinsonian symptoms including a blank look and an odd speaking voice.) Sometimes she just seems like a normal person; sometimes she sees "trolls" and asks my father if he's real or repeats the same question over and over. My last visit she read a long story in a magazine and gave me an accurate summary about an hour later. Is there anyway to get her to be at her best more of the time?
Knowledge of the dosages of these medications would be helpful to understand better this case. Nonetheless, if I had a patient like this, I might systematically and slowly start tapering and discontinuing medications, starting with Ativan. The next one might be Mellaril. I might leave a week or so between the discontinuation of one medication, before starting the discontinuation of the next to observe the patient.
poster:Dr. Bob
thread:59588
URL: http://www.dr-bob.org/babble/20010417/msgs/60177.html