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been withdrawn and no difference has been detected.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
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Steve A. Dunleavy ([log in to unmask])
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