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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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My wife (74yo, alzheimers, vascular dementia) takes donepezil

Resolved Question:

My wife (74yo, alzheimers, vascular dementia) takes donepezil and memantine. She has presented symptoms of epilepsy(explosive exhalation, body tremors) occasionally. In the latter part of 2014 there were two occasions when she experienced three tremorsin the space of ten minures. Nine days ago she had eight events of increasing violence with no ill effects. When I notified the Memory Clinic I was told to reduce donepezil to 5mg days and then stop. When I demurred because I am concerned that what theapeutic benefits accrue from the drug would be lost beyond recovery! I was told that the memantine was a strong drug and would suffice. My concern now is that since 2011 my wife has had several consults/reviews with medical staff at the Clinic and the potency of memantine has never been mentioned. I am worried that stopping the donepezil might accelerate my wifes deterioration and would rather maintain the 5mg to see what develops am I being unduly obstinate?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Dr Basu :

there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

I do understand your concern.

Dr Basu :

Your wife may have had seizures from AD itself.

Dr Basu :

However, Donepezil can worsen the seizure problem potentially.

Dr Basu :

Studies have shown the better outcomes with memantine and donepezil combination.

Dr Basu :

And Memantine alone is also stronger than donepezil alone.

Dr Basu :

So, this is a complex decision making process.

Dr Basu :

If your wife does not get seizures any further with an antiepileptic medication like Levatiracetam, then donepezil may be continued at 5 mg daily with memantine.

Dr Basu :

But any further seizure episode should warrant discontinuation of donepezil completely.

Dr Basu :

Best wishes,
It was my pleasure to help you today.
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Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29251
Experience: MD
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Expert:  Family Physician replied 2 years ago.
I would have to respectfully ***** ***** the previous answer.You should NOT continue this medication without the advice and consent of the treating physicians.