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92-yr old Mom, in AL with mild dementia and severe hip osteoartritis. Wheelchair-bound, recently lost husband. She lives in NC and i visit fron GA every 1 to 2 weeks for a few days.

She has been doing ok, gets a little confused/forgetful, but otherwise she is doing well with just a very gradual mental decline. She has been showing signs of depression, like no interest in food or activities, staying in bed a lot. Her pain has been difficult to manage. Can't take nsaids, so its been tylenol, eventually adding tramadol. Week and a half ago, the NP started her on oxycodone which seemed to ease her pain finally, but did make her a bit goofy. She still had her senses though and was aware of her surroundings, routine, people, etc.

Before I left for the trip back home, the NP visited again, and checked her out. We all discussed her depression, and she agreed to trying something to lift her spirits. NP started her on Cymbalta, low dose, with increase scheduled 2weeks.

I called her first day on Cymbalta mom said she felt weird, but pain was ok. Next day i called, and brother called too, she was hallucinating! Seeing and hearing things, totally whacked. I alerted the nurse at the AL and they also confirmed she was messed up. So we thought maybe the Cymbalta, and they stopped her next dose. The NP saw her next day, and is puzzled at the reaction...and now 2 days later, with no Cymbalta, Mom is still very delirious. She thinks she's got to get the laundry and ironing done, she's got to cook dinner, clean house, etc. And, sadly, she thinks my dad is on his way to help.

Anyone experience such a dramatic rapid change in conscious reality? Either from meds or dementia? Last night I also asked the nurse about a UTI, so today might request test for that.

Thank you for any advice, experiences, support.

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Any AD can cause a myriad of mental changes.

I took Paxil and hallucinated after ONE small dose. Scared me to death. Zoloft works, but I had to play around a little with the meds.

Cymbalta was not a good choice for me either. Good news is, once it's out of her system, she'll be OK.
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It can take a bit to get a medication out of her system, so if she's a little better now, she's likely getting it out of her.
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BeagoBarb Feb 2022
Thank you for this optimism.
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Thank you, Barb. Things seem better today thankfully. I just talked with Mom, and she sounds very weak. But she was responsive and seemed more aware...much different from the weird rambling from yesterday. The nurse yesterday told me that she had helped my mom use the toilet, and she was paying attention to her urination...she said there was no urgency or pain, and the urine was clear. So maybe it was the Cymbalta, as now its been over 48 hrs since last dose. I'm going up tomorrow for a few days, so I will definitely watch her symptoms.
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Good lord, why hasn't she been evaluated for an acute infection?

This sort of mental status change is a medical emergency and should be treated as such.

From experience, I can tell you that UTIs in elders turn into sepsis with terrible speed.
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BeagoBarb Feb 2022
Sorry, my reply to you is above. Thanks so much!
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