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Namzaric and Daytime Sleepiness no Energy

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Hi Dr. Okun,

My 82 year old Mom has Parkinson dementia for the past three years. I am hoping you can assist me. About three weeks ago my Mom's neuro put her on Namzaric,  ( She is still on the last week of the 28 day starter back ). Because this is a combination of Namenda and Aricept, I am giving this to my Mom in the morning. I am aware this should be given before bedtime but when my Mom was on 10 mg Aricept alone for 2 years she had horrific nightmares so I started giving it to the AM about a year ago. The following is her medication schedule:

5 AM Carp/Lev

7:30 Namzaric

10:00 AM Carp/Levodopa

2:00 PM Carp/Levodopa

5:00 PM Carp/Levodopa

7:00 PM amlodipin

My Mom is always extremely tired now, (the neuro has stated unless your left hand shaking bothers her, she can go to 3 carp/Lev a day. ) Her lack of energy is to the point where she could walk the mall in the morning with her nurses aide three weeks ago, and today she lacks any sort of energy for walking, Do you think the timing of her meds need to be adjusted ? I know Aricept is in Namzaric but do you think I can retry before bedtime again ? or do you think it will be the same result ?

My Mom has always gone to bed early,( 7:30 PM)  as she is an early riser. Any help will be greatly appreciated !!


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You should definitely work with neuro doc and changing timing may work, but in some cases we stop the medicine when this happens.

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Usually we would reduce it and then potentially stop it.  If you can spend a week or so at each dose you might get a feel for whether it is fatiguing.

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