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You wrote: > >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been withdrawn and no difference has been detected.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]) >----------------------------------------------------------------------- ----- > > Steve: I have some concern that Janet may have something other than PD. Did she have a complete neurological workuop, this including a CT or MRI scan? There are other conditions (brain tumor, hydrocephalus, vascular disease) that can mimic PD and which have their own treatments. As to the medications, they can produce side-effects as mentioned by you above. Please keep us posted. Best, Bob -- ******************************************************** Robert A. Fink, M. D., F.A.C.S. Phone: 510-849-2555 Neurological Surgery FAX: 510-849-2557 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 USA E-Mail: [log in to unmask] CompuServe: 72303,3442 America Online: BobFink "Ex Tristitia Virtus" ********************************************************