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Suggest treatment for short term memory loss in a person with COPD

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Posted on Sat, 7 May 2016
Question: five to six weeks ago my husband starting having problems with short-term memory loss. saw family physician. he recommended see a psychiatrist. we did. she recommended a brain scan and medication to help him sleep. had the brain scan done and found nothing. now for the last three or so weeks he started hallucinating. seeing things and hearing things. called the family dr. and he said he couldn't do anything else for him. recommended seeing the psychiatrist again. you also should know that he is stage 4copd. he also had open heart about fifteen years ago. he gets very agitated at times and is very jittery. hard for him to sit still for any length of time. also loss of appetite and loss of sleep.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

From what I understand your husband has had an acute deterioration with psychosis (hallucinations) on the basis of some previous memory impairment. It is unclear what was the psychiatrist conclusion after the first visit apart from the scan and giving an antidepressant, did she perform any tests for cognitive functions, was the diagnosis of dementia mentioned. It would have been desirable if the patient was checked by a neurologist rather tha a psychiatrist for the memory loss, as dementia it's more of a neurological diagnosis and on neurological exam might have been evidenced of other signs such as parkinsonism for example.

I am asking as short term memory loss is one of the manifestations of dementia. If a patient has dementia he is more prone to have delirium episodes with hallucinations. The trigger in such vulnerable patients may be many. One possible cause in your husband may be hypoxia due to copd. Other causes may be dehydration, malnutrition, infections etc, anything disrupting balance.

So in this case first a general check for blood gases, metabolic panel and blood count is necessary, abnormalities should try to be corrected. In the meantime hallucinations must be trated with an antipsychotic (such as quetiapine, olanzapine) at least temporarily (they have their own risks so used only to control patients when hard to handle). If he gets better a neurological evaluation for dementia is necessary and if confirmed treatment for it (to slow evolution down) is initiated.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

Answered : 3668 Questions

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Suggest treatment for short term memory loss in a person with COPD

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. From what I understand your husband has had an acute deterioration with psychosis (hallucinations) on the basis of some previous memory impairment. It is unclear what was the psychiatrist conclusion after the first visit apart from the scan and giving an antidepressant, did she perform any tests for cognitive functions, was the diagnosis of dementia mentioned. It would have been desirable if the patient was checked by a neurologist rather tha a psychiatrist for the memory loss, as dementia it's more of a neurological diagnosis and on neurological exam might have been evidenced of other signs such as parkinsonism for example. I am asking as short term memory loss is one of the manifestations of dementia. If a patient has dementia he is more prone to have delirium episodes with hallucinations. The trigger in such vulnerable patients may be many. One possible cause in your husband may be hypoxia due to copd. Other causes may be dehydration, malnutrition, infections etc, anything disrupting balance. So in this case first a general check for blood gases, metabolic panel and blood count is necessary, abnormalities should try to be corrected. In the meantime hallucinations must be trated with an antipsychotic (such as quetiapine, olanzapine) at least temporarily (they have their own risks so used only to control patients when hard to handle). If he gets better a neurological evaluation for dementia is necessary and if confirmed treatment for it (to slow evolution down) is initiated. I remain at your disposal for further questions.