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What Causes Bed Wetting In An Elderly Person?
Question: Hi sir
We discussed regarding my farher's condition.
In first 2 weeks we felt he was improving.but suddenly his symptoms changed.
1. He is getting good sleep, but doing bed wetting early in the morning even if he is awake. He is just don't wanna change his position.
2. He is not sleeping in Daytime. He sit at one shop for 4-5 hours continuously .
3. He is responding very very slow for everything we told him to do. Like if we ask him if he need more food. He will not respond 5-6 times. Then when asked forcefully he will reply yes or no. but again he will change his decision many times..yes no, no yes, yes no.
This is happening in all the tasks.like if he is putting some object in almira , then he will move his hand to put but then pull back his hand. And do this many times. Like he is confused he should do it or not.
We have to ask him many times to do anything and sometimes we need to force him to do.
His medicines are-
Thiamine 100 twice, escitalopram 10 once, alzil -M 5mg, osteocobal, and mirtazapine 7.5 mg once in night.
We discussed regarding my farher's condition.
In first 2 weeks we felt he was improving.but suddenly his symptoms changed.
1. He is getting good sleep, but doing bed wetting early in the morning even if he is awake. He is just don't wanna change his position.
2. He is not sleeping in Daytime. He sit at one shop for 4-5 hours continuously .
3. He is responding very very slow for everything we told him to do. Like if we ask him if he need more food. He will not respond 5-6 times. Then when asked forcefully he will reply yes or no. but again he will change his decision many times..yes no, no yes, yes no.
This is happening in all the tasks.like if he is putting some object in almira , then he will move his hand to put but then pull back his hand. And do this many times. Like he is confused he should do it or not.
We have to ask him many times to do anything and sometimes we need to force him to do.
His medicines are-
Thiamine 100 twice, escitalopram 10 once, alzil -M 5mg, osteocobal, and mirtazapine 7.5 mg once in night.
Brief Answer:
Please read below
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
I am slightly relieved to know that he was doing well in most regards over the last 2 weeks.
Regarding change in situation suddenly the first possibility is weather change. As per my knowledge you reside in XXXXXXX and excessive cold could be one reason for change in his bed wetting problem as decreased temperature leads to more urine formation and increased frequency of urine.
Regarding indecisive behaviour (Yes No Yes No) the first possibility is lack of motivation. The apathy and amotivation are regular thing with alcohol associated dementia and I am hopeful that either modafinil or armodafinil can be considered for this part. The dosage are 100-200 mg for modafinil and 50-150 mg for armodafinil. As you know I am not supposed to prescribe this can be discussed with your doctor on next visit. I recommend dose of 100 mg for modafnil and 50 mg for armodafinil if your doctor agrees to prescribe.
The medicine also likely to help in bed wetting as there is more motivation and energy and your father may decide to visit bathroom specially when he is awake.
Among the current medicines as I suggested earlier go for Alzil-M 10 (donepezil 5 mg and memantine 10 mg).
I hope this helps him at this point.
Thanks and regards.
Please read below
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
I am slightly relieved to know that he was doing well in most regards over the last 2 weeks.
Regarding change in situation suddenly the first possibility is weather change. As per my knowledge you reside in XXXXXXX and excessive cold could be one reason for change in his bed wetting problem as decreased temperature leads to more urine formation and increased frequency of urine.
Regarding indecisive behaviour (Yes No Yes No) the first possibility is lack of motivation. The apathy and amotivation are regular thing with alcohol associated dementia and I am hopeful that either modafinil or armodafinil can be considered for this part. The dosage are 100-200 mg for modafinil and 50-150 mg for armodafinil. As you know I am not supposed to prescribe this can be discussed with your doctor on next visit. I recommend dose of 100 mg for modafnil and 50 mg for armodafinil if your doctor agrees to prescribe.
The medicine also likely to help in bed wetting as there is more motivation and energy and your father may decide to visit bathroom specially when he is awake.
Among the current medicines as I suggested earlier go for Alzil-M 10 (donepezil 5 mg and memantine 10 mg).
I hope this helps him at this point.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reply.
You also mentioned about stopping mirtazapine earlier.
Can that be helpful.
Also since he does not blink his eyes , tears keep flowing all the times .
You also mentioned about stopping mirtazapine earlier.
Can that be helpful.
Also since he does not blink his eyes , tears keep flowing all the times .
Brief Answer:
You are always welcome
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
The presentation over the last two weeks have changed such as he is sleeping during night only, adequate sleep during day, evidence of depressive symptoms along with amotivation.
I my opinion none of the symptoms can be attributed to mirtazepine so it can be kept for time being as it is possible that it is helping at least for night sleep. Infact low dose of mirtazapine is good sleep medicine but during our last interaction there were many medicines to make him sleep, leading to excessive sedation and enuresis so I decided to keep it onside along with other sleep medicines.
I hope this clarifies.
Thanks and regards.
You are always welcome
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
The presentation over the last two weeks have changed such as he is sleeping during night only, adequate sleep during day, evidence of depressive symptoms along with amotivation.
I my opinion none of the symptoms can be attributed to mirtazepine so it can be kept for time being as it is possible that it is helping at least for night sleep. Infact low dose of mirtazapine is good sleep medicine but during our last interaction there were many medicines to make him sleep, leading to excessive sedation and enuresis so I decided to keep it onside along with other sleep medicines.
I hope this clarifies.
Thanks and regards.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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