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Suggest Remedy For Hallucinations And Dementia When On Aripiprazole

Posted on Mon, 1 Jun 2015

Question: 1. Concerned as aripiprazole prescribed, numerous side effects, been taken for 3.5 months. Quality of life very poor since on this. concerned if bionanserine or paliperidone is prescribed as alternative as has atrial fribullation, vascular dementia, kidney and bladder problems and asbestosis. 2, post traumatic stress disorder exists but not diagnosed formally, has regular U.T.I's and developed hallucinations when has U.T.I's, has dementia and concerned that psychiatrist is classing the hallucinations as part of a mixed dementia. I do not believe this is a correct treatment. 3. sertraline prescribed but never depressed previously, no diagnosis of depression. Please advise

Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
Hallucinations can occur in dementias

Detailed Answer:
Hello, Welcome to Health Care Magic

I can understand your concern. If we consider pharmacology of Aripiprazole then it is a second generation antipsychotic drug. The drug is considered as metabolic safe drug and is relatively safe to use. If we consider efficacy of the drug in comparison of Paliperidone then both drugs have almost same efficacy. There are not much research studies for Blonanserine but in some initial studies it has been found to be safer in comparison to other antipsychotic drugs so relatively better tolerated. If Aripiprazole is not resulting in improvement then Paliperidone can be tried. Some times if a patient doesn't respond to one drug then he may evenrespond to other drug. Paliperidone should help in controlling the symptoms.

Metabolic abnormalities especially electrolyte imbalance can cause hallucinations and other symptoms. UTI may cause electrolyte abnormality which can result in hallucinations but if electrolytes and metabolic profile is normal then no need to worry about that. At 68 years new onset psychotic disorder is not common so the hallucinations could be occurring due to dementias, though detailed evaluation is needed to confirm diagnosis.

Sertraline would help to improve the mood. The drug will also help to improve symptoms of PTSD, so in my opinion this is the reason for prescription of Sertraline.

Thanks, Hope this helps you, if you have more doubts you can ask again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (13 hours later)

The UTI's started the hallucinations it then became evident that the PTSD was a problem. He had suffered for many years and managed well although it did cause him to need to talk about it periodically over the years, although not often. His dementia suddenly advanced when in hospital at the end of the UTI and he was symptomatic of PTSD but not diagnosed, his mood pre admission was anxious periodically when UTI's but generally happy, concentration good, eating and drinking well. So should we assume that it is irrelevant as to whether the dementia is causing it. When aripiprazole was not taken for 24 hours he improved dramatically. His mood on the medication is low. Should we accept this even though we do not agree with emphasis on the dementia which was not too bad, fairly described as deteriorating slowly until the admission to hospital. Thanks

Answered by Dr. Seikhoo Bishnoi (9 hours later)

Brief Answer:
Probably he is not tolerating aripiprazole

Detailed Answer:
Hello again

If the symptoms got aggravated during UTI then it is possible that at that time he developed electrolyte imbalance. This caused rapid development of dementia. His anxiousness and mood swings are probably getting aggravated with Aripiprazole as you have mentioned.

Please discuss with his doctors and ask about switch to some other antipsychotic drug in equivalent doses. This should reduce his symptoms. I don't think dementia is causing mood changed to such extent.

Thanks, Hope this is helpful. Please ask again if you still have more doubts.

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Above answer was peer-reviewed by : Dr. Yogesh D