
Suggest Remedy For Dementia In A Hypertensive Person

I apologize for writing without the benefit of an introduction, but do so on behalf of my mother in law (Smt XXXXXXX Mishra) is suffering from Dementia disease since XXXXXXX 2013. Most probably she got the attack of this disease after sudden death of her sister in law in the year 2012. On consultation of doctor in 2013, he had advice for medicine but could not be continued even for a week due to disorder in her abdomen like formation of gas etc. At present she is not taking any medicine for this disease. Although she used to take medicine for high blood pressure.
At present she is having following type of problem:-
1. Gradual loss of memory. She is unable to recognize her family members and who is older or younger than her.
2. Sometimes she is having no control on urination.
3. Have developed childish behavior.
4. If she keeps some household item at certain place becomes unable to recapitulate the place where is kept it.
5. Always someone has to remind her for daily routine work such as cleaning of teeth, washing of face, bathing and eating etc.
6. In the day, she prefers to walk here & there without any work.
Consultation History-
1. Dr XXXXXXX Sharma- Neurologist, Ranchi- Prescription & CT Scan Report enclosed.
2. Dr Madhurendra Prasad- Neurologist, Silliguri-Prescription enclosed.
3. Dr XXXXXXX Mishra- Neurologist, Silliguri- Prescription, MRI Report and Hospitalization test report & discharge certificate enclosed.
4. Dr XXXXXXX XXXXXXX Singh- Neurologist, Patna- Prescription enclosed.
5. Dr XXXXXXX Parikh, Psychiatric, Fortis Hospital Gurgaon- Prescription enclosed.
We understand that this is one of many such requests that come across your desk and greatly appreciate any guidance that you can lend.
Thank you, in advance, for your help. I look forward to hearing from you at your earliest convenience.
Complete cure is not possible, some benefit can be expected.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted the details of your mother-in-law. I agree with the diagnosis of severe dementia, most probably Alzheimer's disease (AD).
Unfortunately, AD is not curable, and tends to progress over time.
Medications that can help her to a limited extent are:
1. Donepezil,
2. Memantine,
3. Piracetam.
For behavioural changes, quetiapine can help her.
She would need help of a caregiver for her daily activities.
I hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


The medicine (EXELON PATCH 5 & ALFA-GPC) prescribed by Dr XXXXXXX Parikh is to be continued or not.
You are requested to please send your advice and medication in your prescription for further assistance.
Sir, can you please provide your number to contact you.
Thanks/Regards,
XXXXXXX XXXXXXX
0000
Exelon patch and ALPHA GPC may be continued.
Detailed Answer:
Thank you for getting back.
Exelon patch (rivastigmine) can be continued. This is similar to DONEPEZIL. So, only one of the two- exelon patch or donepezil- should be used.
ALPHA GPC can also be used.
The prescription can be given after seeing the patient, so, you will need to get it prescribed by the local doctor.
The follow up query can be asked here on this thread, and I would be pleased to answer them. As of now, discussion on phone is not possible.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)


If Exelon Patch or Donepezil both are same then we will start Donepezil and pls send the doses of below medicine:
1. Memantine,
2. Piracetam.
3. Quetiapine
Thanks/Regards,
XXXXXXX XXXXXXX
Usual doses are given below.
Detailed Answer:
Thank you for getting back.
1. Memantine is started at a dose of 5 mg per day, and it can be increased to 10 mg daily after a month or so.
2. Piracetam is given at a dose of 800 mg two times daily, and it can be increased to 1200 mg two times daily.
3. Quetiapine is given at a dose of 25 mg bedtime, and it can be increased/reduced depending on the patient condition.
Donepezil is also started at a dose of 5 mg per day and can be increased to 10 mg daily.
Since these are prescription medicines, you will need to get them prescribed by your local doctor.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
