It is a shame that Donepezil has not suited your mother, it did wonders for my hubby, maybe the GP can give her something else.
Hi pamann,
Yes, it is indeed disappointing but I'm pleased that it helped your hubby.
My mother is not under the GP for the prescribing and monitoring of donepezil.
She was GP referred to the local memory clinic service for assessment. The clinic staff carried out a domiciliary assessment and ordered a CT scan and it is the clinic's consultant (whom she has never seen) and the community psychiatric nurses (CPN) who are currently responsible for assessment, confirming a diagnosis and titrating any medications the clinic suggests she might try.
At some point, the monitoring of any ongoing medication will be transferred to the GP surgery, and then the memory clinic will review her on a six monthly basis - but we are not at that point yet.
However, I was told yesterday, by the GP who made the house call, that although the surgery currently defers to the memory clinic team, if we have any issues with the memory clinic regarding current or future management of any medication the clinic has her on, to get back to him and he will liaise with them.
If my mother is put back on the 5mg dose, today, perhaps we might see some improvement after a few more weeks.
But the way she has been this last 10 to 14 days (whilst taking the 10mg dose) has rendered her barely well enough to be living on her own, so it may be decided to take her off it completely - I am hoping she
will be taken off.
(She could possibly try 5mg again if she wanted to when she is back to what is more like "normal" for her.)
I advocate for my mother from a long distance (which is fraught with communication problems, especially given the current state of her memory, and I am not the primary family member contact for the CPN) but the CPN is planning to update me this afternoon, after he has decided how to proceed.
I shall be asking whether the recent morning hand trembling might be an extrapyramidal side effect from the higher dose of donepezil.
She has also had two episodes of TIA-like symptoms since she has been trying donepezil for which a GP ordered ECG, bloods. An appointment for an echocardiogram is also expected within the next four weeks.
She's been told by one GP at her practice that these TIA-like episodes may have been "muscular". But I was advised by the different GP, yesterday, that any future TIA-like symptoms should continue to be treated as a potential TIA/evolving stroke until otherwise ruled out. The 111 triage nurse also thought these sounded like possible TIAs.
Donepezil can cause muscle spasms. So it's not known for certain whether these transient symptoms may have been a side effect of the donepezil, were TIA associated or are incidental symptoms of little medical significance. As the 111 triage nurse said, there is a lot going on here: trialling donepezil, while being taken off one BP med and being put on another, having the new med then stopped by the hospital and experiencing several as yet unexplained symptoms which may or may not be related to (or being exacerbated by) the donepezil.
I have suggested that she considers coming to stay with us for a few days so I can keep a closer eye on her and also feed her up a bit, but the CPN wants her to stay within his area so he can monitored her until she regains her previous level of memory and functioning. I can't easily stay with her due to carer commitments within my own family.
I should know more later today.