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Lucy & David Hartley wrote: > > Hello Everyone; > > My dad, 77/10, has recently dipped into a downward spiral. Prior to his > decline, he was managing fairly well, with my mother as his full-time > caregiver. > > He had begun experiencing some mild hallucinations and paranoia over the > past 6-8 months, but nothing extreme, and usually only at night. He was > coping reasonably well with life and his illness. > > His on/off times were fairly consistent with med intake. His med > and exhibits irrational, psychotic behavior, does this not constitute a > medical emergency? > > Can my dad expect no more medical assistance than this? > > I would be grateful for your thoughts, comments, advice. > > Lucy Hartley LUCY: Unfortunately insurance companies now determine what is a medical emergency. He can be admitted if he pays for it himself. The Doctors involved can also appeal the Ins Co ruling, but many do not want to bother. They too can get discouraged with the constant hassels. My suggestion would be to start Clozaril (an anti-psychotic drug) which has shown the most effectiveness in PWP. Return to the original meds if they were giving a satisfactory response. Clozaril is usually effective in PWP in small doses and has the added advantage of causing drowsiness, which should help your father sleep. Many Physicians are afraid of Clozaril because it can cause blood dyscrasias in a small number of people. There are weekly blood counts required to spot a problem and an early intervention can be started, if necessary. There is usually no problem if the proper protacol is followed. Many Neuro's prescribe the Clozaril so it is not necessary to have a Psychiatrist, unless your Neuro feels more comfortable. If you have any more questions please feel free to contact me. Jerry Starr, RPh.