AboutMary E Scott, RPh, CGP Expertise I am a certified geriatric pharmacist with over 23 years experience as a long-term care consultant to nursing homes. I also do community-based consulting on an individual basis. My facility-based monthly newsletter on pharmacy topics is read by nurses in over 200 long-term care facilities in 5 states.
Experience I received a BS in Pharmacy in 1980 with post-graduate work in public health. I have had a Consultant Pharmacist license since 1984.
Organizations American Society of Consultant Pharmacists .I received certification in geriatric pharmacy in 1998.
Question QUESTION: My 92 yr. old mother (who lives w/ us) has had 2 strokes in the past 11 years. She had mild dementia until Sept. '06 when she was hosptalized with reaction to Namenda. She was taken off Wellbutrin (300 mg/day) shortly thereafter and this got rid of the hallucinations. 2007 was a roller coaster year..She had 2 bouts of pnuemonia which were treated w/ Levaquin as well as a U.T.I which was also treated w/ Levaquin. Her memory began to deteriorate about the same time. She has been taken off Hydrocodone/apap because of confusion and constipation..it helps her constipation alot but didn't touch the confusion. In Dec. she was put on Trazodone (25 mg for sleep) and then it was cut to 12.5 mg. because of over sedation. She has been completely off the Trazodone for 13 days now and she is still sleeping approximately 20 hours or more a day. She has been taking 100 mg. Wellbutrin for 3 weeks now because of severe depression. Is it possible that her body did not metabolize the Trazodone and it is not being excreted? She was diagnosed w/ kidney compromise several years ago. She is upset all the time because, as she says, "I don't know anything"...meaning memory and it is very bad now....she doesn't remember day to day. Is it possible that the anti-depressant will eventually start working and bring her out of this? Is it possible that this is caused by depression?
Is it possible that she could be helped by Exelon patch? (my pharmacist recommends it) There is no quality of life here at all and it breaks my heart. Always before when she got bad, it was the result of a medication and when she was taken off the med, she got back to 'normal'. I am about to
lose hope here and I have never done that before. Is it possible that her 'sleep/wake' cycle was changed to the present one because of the Trazodone? help!
ANSWER: Hi,Carole!
I would have to look a list of her meds to determine if a med or combination of meds may be causing the disruption in her sleep/wake cycle. If you could send me a followup with her meds (strength, directions,and time she takes them) I can look them over. Hope this helps, Mary
---------- FOLLOW-UP ----------
QUESTION: She takes 75 mg. Plavix once a day, 100 mg. Wellbutrin once a day, a multi-vitamin, 1-Optic Nutrition capsule, 1-CranMax capsule, 1-81 mg. baby aspirin, 2-Arthritis strength Tylenol 2 times a day, and will soon re-start Betoptic S, 1 drop 2X day.
Answer Hi,Carole!
From what she is taking, it doesn't seem as if the somnolence is caused by her meds. Depression can cause someone to want to sleep excessively. Depression is very common after stroke and can be compounded by frustration that her memory is going.
She could try the Exelon patch but insomnia is a side-effect in about 10% of people that use it,so that is something to consider. You could ask her doctor for a referral to a sleep clinic,also to see if her sleep/wake cycle is altered and what they would recommend. Hope this helps, Mary
