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CABG surgery done. Taking donepezil for forgetfulness. Become hyperactive and aggressive. Suggestion?

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Practicing since : 2009
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Hello doctor, I am based in Germany and have a query wrt my father in India.
He is 73 years old and has been depressive since a CABG surgery several years ago. While things were stable of later he has been more forgetful for which the doctor in India prescribed donepezil a couple of months back. Since then he has been very hyperactive, aggressive and has short attention span. I heard this from my mother and family members in India.Could this be related to the medication ? Given that I am in Germany, think I should also talk to his doctor and get his views. Could you suggest what else could be done?
Posted Thu, 28 Feb 2013 in Mental Health
Answered by Dr. Sundar Gnanavel 24 minutes later
Thanks for your query. I understand your concern with your father's mental health. Donepezil is an acetylcholine esterase enzyme inhibitor routinely prescribed in dementia. However, a frequent side effect we encounter is increase in behavioural abnormalities like agitation and hyperactivity particularly in those with a type of dementia called frontotemporal dementia. The other possibility is that it is not drug related but a progression of dementia itself that can present similarly. I would suggest you reduce the dosage or stop donepezil for atleast 2 weeks to observe the symptoms. Later if the symptoms do not decrease a re evaluation for dementia by a neuro-psychiatrist or neurologist is required. Low dose antipschotics like quetiapine are prescribed in such circumstances generally. Do clarify anything else you may want to.
Dr Sundar
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