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Kathie, Your friend sounds like he is in serious trouble and is lucky to have friends like you and the rest of your group. Olanzepine is a new (within the past year) neuroleptic which is not supposed to block striatal dopamine nearly as much as the "standard" antipsychotic drugs. If he were on it prior to the episode you mention then his neurologist or psychiatrist was likely concerned about his mental status and was treating him. Any of the drugs he is taking except the olanzepine can cause psychosis or confusion- Unfortunately so can the PD. If in your opinion he is still confused or psychotic and you feel there is a good possibility of him not taking his meds properly or remains in danger talk to the home care person about your fears and observations. Also call or write the psychiatrist or neurologist. Clozaril is an alternative to olanzepine if the later is not working. Do you know if he was treated for mental illness prior to his PD? It is a frustrating situation for which you may be able to do nothing that has a positive effect. Good luck and let me know what is happening. Charlie Kathie Tollifson wrote: > > I have a friend from my Young-Onset group that has been in a serious > crisis > for a week, and I don't have a solution. Maybe some of you veterans > can > shine some light? > > Ron is about 55, taking anti-parkinsonian drugs for 5 years or so. He > is > prescribed (4) 25/100 sinemet CR, (4) 2.5 permax, (2) 5 mg eldepryl, > plus > an antidepressant called Olanzepine ( I think) that he takes at night > before > bed. For some reason his second dose of eldepryl is prescribed > specifically > to be taken at bedtime also. > > He has always seemed a little less in touch than the rest of us in the > YO > group, but lately he is much more confused, so we started visiting him > occasionally to see if he was OK, he lives alone. Last week one of the > men > from the group called me in great alarm, said Ron had taken all 4 of > his > sinemt at once, and was confused and hallucinating. Over the next few > days > it became apparent that he was hallucinating all the time, whether he > took > his pills or not, and that he was so confused that he was usually not > even > remembering his meds. Last Wed he went to Burger King, and I'm not > sure > what all happened, but 3 hours later the fire dept brought him home. > That > night I took him to the emergency room, mainly because I couldn't > leave him > alone in the state he was in, and I had no solutions. They kept him 5 > days, > the last 3 in the psychiactric ward, and the psychiatrist told me he > had > diagnosed Ron as psychotic. > > Monday they tossed him out on the streets with no change in meds, and > three > days of Home Health visits arranged, and a caution to me from 3 > different > doctors to not let him drive. Here we are now, with little > improvement, Ron > can not figure out his meds, he freezes for long periods, and is still > extremely confused. > > I don't know what to do. He is not safe alone, but wishes to remain > independent. Apparently he has the resources to afford some domestic > assistance, such as a part time companion, and I am willing to help > with his > meds, but I wonder if this isn't just putting off the inevitable, and > also > exposing him to great danger. I frankly don't think his hallucinations > are > tied to the sinemet because he has them even when he is very off. But > I'm no > expert on PD-related hallucinations and psychosis. > > HELP!! > > Kathie Tollifson > [log in to unmask] > 47/9 -- CHARLES T. MEYER, M.D. Middleton, WI [log in to unmask]