Dementia: Neurologist vs Psychiatrist

January 13, 2010 at 1:34 am Leave a comment

Using our personal experience, we learned that the most useful physicians to rely upon for help when dealing with dementia patients are BOTH a neurologist and a psychiatrist.  Most people will take their loved one to a neurologist for diagnosis and for drug therapy treatment regarding memory loss.  What seems to be lacking is the use of a psychiatrist to deal with the behavioral and inappropriate actions that dementia patients face.  A psychiatrist can serve as a wealth of knowledge in helping to treat patients with the appropriate drug therapy.  Often we hear stories of the patient not sleeping and wondering through the house at night doing repetitive things like emptying drawers and closets.  This is exhausting not only for the patient but also for the family members.  It can lead to frustration for the caregiver and earlier than needed admission to a nursing home.  Our mother was acting in a similar way and she became obsessed with her teeth. All night long the constant flossing and brushing was driving us crazy.  She was constantly emptying her closet and then putting the clothes back in over and over again.  We just wanted her to relax and sleep.  As pharmacists we are well aware of medications used for obsessions and also medications used for calming.  Sadly, anti-anxiety agents, such as the benzodiazepines, are not recommended because they can worsen cognitive impairment.  So, what can caregivers do?  Please visit a psychiatrist and discuss the problem with him/her.  We insisted upon medication that comes from a class of drugs called atypical antipsychotics.  We have seen that these medications are very effective in reducing agitation and inappropriate behavior.  It certainly helped our mother.  These drugs have a Black Box Warning, stating that using this class of drugs can increase the risk of death in elderly patients with dementia.  You and your doctor will have to decide if the benefits received from these medications are worth it.  We have decided that the quality of life far supersedes the adverse affects.   It is a very personal decision that your doctor can help you make.   Also medications are available for obsessive compulsive disorders and depression if your loved one needs them.   If your doctor refuses to prescribe any of these medications (like the first psychiatrist we visited) you can always make an appointment with another one.   For us it is all about quality of life and these medications certainly helped us with that.  Our mother sleeps peacefully, about 12 hours every night, and most of her obsessions have disappeared.  It is very important to remember that the psychiatrist should become part of your healthcare team and looked upon as an answer for problems you and your loved one will face.


Entry filed under: Dementia. Tags: , .

Dementia: Getting the Diagnosis Dementia/Alzheimer: Medications

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