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KarayanMD
KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 805
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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4 yrs. ago, my Mom was forced to retire from a job she loved

Customer Question

4 yrs. ago, my Mom was forced to retire from a job she loved and had some other life stressors-- IE: loss of.elderly acquaintances. She became depressed and, more notably, "crippled" by anxiety: Couldn’t sleep, lost a lot of weight, was afraid to leave the house, etc. She refused 'talk' therapy. Two antidepressants did nothing. Another seemed to “make” her hallucinate. Both a psychiatrist and a neurologist didn’t think she had dementia, because her memory (and MRI, EEG, etc) was normal. But, when she went off the drugs, the hallucinations continued w/paranoia, delusions, trouble finding words, not showering, etc. Now, at 79, she full-blown dementia, My question, did the depression CAUSE her dementia? Even though there's no definitive answer, can't help wondering if this could have been "prevented" or "delayed" (she seems young for this) if she’d gotten a volunteer job, went for therapy, done something else to get herself out of the slump? When someone has this disease, was it an inevitability?
Submitted: 1 month ago.
Category: Neurology
Expert:  Dr. David replied 1 month ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 1 month ago.

I am sorry about your mother.

the depression would not cause her dementia

but she could have Frontotemporal dementia

this is a specific condition with specific treatment which is more than just antidepressants

ask to see neurologist to see if she has frontotemporal dementia which can be treated.

we don't know enough about dementia, most likely it could not have been prevented.

Customer: replied 1 month ago.
what kind of treatment is there? I didn't think there were any
Expert:  Dr. David replied 1 month ago.

antidepressants along with antipsychotic medications and trazodone can help

sometimes a combination of medications is needed.

Customer: replied 1 month ago.
Are you a neurologist?
Expert:  Dr. David replied 1 month ago.

I am not a neurologist.

but I have seen patients who have dementia

she needs to have a dementia workup

has she tried medications like aracept or namanada which can be helpful in patients who have dementia?

Customer: replied 1 month ago.
Please answer ONLY if you are a neurologist!
4 yrs. ago, my Mom was forced to retire from a job she loved and had some other life stressors-- IE: loss of.elderly acquaintances. She became depressed and, more notably, "crippled" by anxiety: Couldn’t sleep, lost a lot of weight, was afraid to leave the house, etc. She refused 'talk' therapy. Two antidepressants did nothing. Another seemed to “make” her hallucinate. Both a psychiatrist and a neurologist didn’t think she had dementia, because her memory (and MRI, etc) was normal. But, when she went off the drugs, the hallucinations continued w/paranoia, delusions, trouble finding words, not showering, etc. Now, at 79, she full-blown dementia, My question, did the depression CAUSE her dementia? Even though there's no definitive answer, can't help wondering if this could have been "prevented" or "delayed" (she seems young for this) if she’d gotten a volunteer job, went for therapy, done something else to get herself out of the slump? When someone has this disease, was it an inevitability?
Expert:  KarayanMD replied 1 month ago.

Hi. Thank you for your question. I am a board certified neurologist in the U.S.

I am very sorry to hear about your mom's condition. I will be happy to help answer your questions.

Expert:  KarayanMD replied 1 month ago.

It is very unlikely that the depression would actually induce or "cause" dementia to occur. Actually, depression does not cause dementia.

Expert:  KarayanMD replied 1 month ago.

It is very possible that the depression and anxiety may have been the first sign of a dementia condition setting in. Dementia often is a gradual process that may take years to be noticeable, while the brain changes may start years earlier. In some cases, mood changes may be early signs of a dementia. This could be the case for the most common type of dementia, which is Alzheimer's disease, but also could be seen even more typically perhaps in other types of dementias, such as frontotemporal dementia or lewy body dementia.

Expert:  KarayanMD replied 1 month ago.

The likelihood is that this may have been inevitable, and treating the depression/anxiety (as was tried) was very unlikely to change the course of the disease. However, in any patient with dementia, it would be important to check some routine blood tests including thyroid function, B12 level, and liver/kidney function, to make sure there is not an easily reversible or treatable cause to the dementia. A brain imaging study is needed as well, but in her case it seems they did do an MRI as you mentioned.

Expert:  KarayanMD replied 1 month ago.

I would definitely advise that she continue to see a neurologist if possible, to fully assess the situation and determine any appropriate treatments.

Expert:  KarayanMD replied 1 month ago.

I hope this has been helpful information for you. Please let me know if there are more questions. If this has been helpful, please rate me highly. Bonuses are appreciated. Best of luck for you and your mother.

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