Drug interactions

[jaki-]

  Hi, I am not sure where to begin, for I have a very complicated situation I am concerned with.
  I will try to be concise.  My stepmother is a long term drug user, drugs of all types, and alcoholic.
  She has rehabbed over ten times.  She is HIV positive, is currently on a methadone program, and visiting a
  psychiatrist, who is prescribing Paxil for her.  She seems high most of the time.  Could this be a cause of
  the methadone and Paxil interacting?  Could it be dementia?  She is also on diability, even though she is  
  not physically disabled, so I am assuming she is considered mentally disabled.  She really doesn't tell us much,
  so I was hoping you had some information.  Thank you.

[CCF Neuro MD*]

_
Dear Jacki,
This is a difficult case because there are several factors that could be affecting how your stepmother is thinking.  When a person initially stops abusing drugs/alcohol there is a period (usually 1-3 but can last up to a week depending on the drugs) that a person experiences acute withdrawl symptoms.  These can include nervousness, tremors, insomnia, confusion, seizures.  The long term use of drugs/alcohol can cause permanent changes in memory function.  In addition,in the later stages of HIV, the most common neurologic complication is a slowly progressive brain infection (encephalitis) presenting as a form of dementia.  Some test that may be helpful to assess the level of dementia and rule out other etiolgies include an MRI, spinal tap, basic blood work and neuropsych testing.  Discuss these options with her doctor.  If you are interested in getting an evaluation at CCF call 1-800-CCF-CARE.  Godd Luck.