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CABG Surgery Done. Taking Donepezil For Forgetfulness. Become Hyperactive And Aggressive. Suggestion?
Question: 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?
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?
Hello......
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.
Regards
Dr Sundar
Neuro-Psychiatrist
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.
Regards
Dr Sundar
Neuro-Psychiatrist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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