Hi everyone: I've been lurking on this list for months, and it's now time to introduce myself and possibly pose a few questions. Before that, however, I would like to compliment all of you who contribute to this list; PD patients, family, caregivers, doctors, researchers, et al., who have so much compassion, information, and time to offer for the benefit of the rest of us. Long live the net when used for purposes such as this. Now for specifics: My dad's wife, Janet, age 68, was diagnosed with Parkinson's in August of '93. The prognosis was that she had a *mild* case, and was prescribed low doses of sinamet, which gave her some relief from the usual symptoms. Within a year however, Janet started having what I would call anxiety or panic attacks, pervasive and dibilitating. These attacks increased in frequency over the last 12 months. The neurolgist treating her insists they were unrelated to either the medication or the parkinson's itself, which, according to further testing, had stabilized and not progressed beyond a mild state. Within the last 6 months, however, Janet's mental and emotional state has steadilly decreased. She suffered from occasional loss of memory, couldn't recognize her surroundings or friends or family, still had anxiety episodes, even wandered away from home a few times, much to the dismay of my Dad, who is the primary caregiver, and her doctors. As her situation has deteriorated, we suspected that she was suffering from depression, and she started seeing a psychiatrist last month, who, I believe, prescribed various anti-depressants or mood elevators, though I'm not sure specifically which ones. Recently, all of this behavior has escalated and she has become paranoid, and with the psychiatrist's approval, Dad had to put her in the hospital for testing and observation. *Those* doctors are now starting to whisper about dementia. What is happening to Janet and what can we do to help her? Does anyone out there recognize this steady, downward, emotional spiral she seems to be afflicted with? We were hoping initially she was suffering side effects from her medication, but that doesn't seem to be the case, as sinamet has been withdrawn and no difference has been detected. Then we were hoping it was *just* depression, which could be treated with medications and/or therapy, but she seems to be slipping away from us so quickly there may not be time for that. Now we are hearing about dementia, and the treating physicians at the hospital want to start administering anti-psychotics. Her long time neurologist, the psyciatrist, and hospital staff offer conflicting information as to waht they think the problem is, and seem to have trouble communicating with each other (and us). Deep down, I think my family is starting to wonder if these people *really* know how to treat Janet, and if so, which one diagnosis to trust? So, a few questions that my father asked me to post: 1. What constitutes the dividing /defining line between depression and dementia in a PD patient? 2. How does, or should, the drug treatment differ for the two conditions? 3. Can extreme depression in PD mimic dementia? 4. If so, for how long? Thanks to all of you. I'll forward all replies and comments to my father. Steve ---------------------------------------------------------------------------- Steve A. Dunleavy ([log in to unmask]) ----------------------------------------------------------------------------