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My mother is 91 and has been taking metoprolol for about ten years. For the past year she's been hearing a man singing for hours at a time, and she sees people who wear white coats in her bedroom. The music disturbs her and the people frighten her. She refuses to see a psychiatrist (recommended by her PCP last winter) and does not want to discuss the matter with her PCP. The above symptoms are listed as "less common" side effects of metoprolol.

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Elderly people are more at risk for side effects from medication. The fact that your mother has been on metroprolol for so long, could mean that the dosage is too high for her aging body. She should see a doctor who will look at a replacement medication, or at least tinker with dosages, unless there's a compelling reason not to. Obviously, she is "old school" and feels people will think she's "crazy" if she sees a psychiatrist, which is very common in her age group.
I'd suggest that you try to get her into a geriatrician - a doctor who specializes in older people. Let that doctor know ahead of time by letter what the problem is. Then, the doctor can make changes without embarrassing your mother (at least there's a chance). Check back if you can. We'd like to hear how it goes.
Carol
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I used to think that if a side effect was going to occur, it would be soon after you start on the drug, but I was surprised to learn that the side effect can start at any time -- particularly if there is a change in your health or in other drugs you are taking, etc. It stands to reason that as we age some adjustments to meds may be needed.
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Thank you very much for your response to my question. I now feel better equipped to discuss Mom's problems with the doctor on Monday and I will let you know the results of the visit. The doctor did change her dose from 50 to 25 mg a month ago, and her BP today was 121/77. I would much prefer that Mom try a different medication before adding a psych medicine. I certainly appreciate the advice and feedback. Aging Care is a wonderful resource.
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she is 91, she dont need large doses of medication, my opinion.
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ELLEN:

If she's taking it for HBP, isn't it odd how a medication can trigger what it's supposed to treat or prevent? Carol is right, the dosage might be too high. She can also take something else with milder side effects.

My mother stressed me out so much I was on Ambien. Sometimes I didn't remember if I had taken it or not, so I'd take another just to make sure I got some quality shuteye. I'd hallucinate, even with my eyes open. The doorknob would slide up and down; squatters in my closet roasting marshmallows, the goddess Jemanja would appear on a wall; robe flapping in the ocean breeze. .. Yikes!

Now I don't even take aspirin, and see my psych 2x a year just to be sure.
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Hey Ellenlh! Not sure about other drugs, but I do know that when my Mom was in the hospital she was hallucinating. Seemed very likely that it was the pain medicine and come to find out, she really can't take anything but Tylenol. It just really wigs her out. I have to say that most of her hallucinting was funny and we would discuss it at great length and laugh about it (man in the corner with a multi-colorful jacket). But, there were also the ones that scared her. My suggestion is to get her off that medicine all together. There are many other medications for HBP that she can try.

I am 51 and my Mom is 75. I met Dr. Radhika Mudiyala in Smyrna, GA at a caregivers seminar. She is our primary care specialist and specializes in geriatrics and has been a Godsend for both of us. She had actually left the office the other day, but came back just to see my Mom! She is a very sweet natured, caring individual in addition to her knowledge of the elderly. She was able to pinpoint a boatload of problems my Mom was having that her prior primary care totally missed. It would be awesome if any of you live in the Atlanta / Smyrna area to take your loved ones to see her, but if not, I would like to suggest that you get your loved ones to a geriatric specialist. They can be hard to find, but well worth the work.

Good Luck to you Ellen! Let us know what happens!
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How is her blood sugar? if you know? My husband is a diabetic and when his blood sugar spikes he "sees" things and acts strangely. He also takes metoprolol (not sure of dose) and has for 4 years now. I don't remember if he has any complaints other than an upset stomach.
Medications are a funny thing! What works for one may react the opposite for another. Try to rule everything out before introducing psych. meds. My mother with Dementia has been on psych meds and thats a "roller coaster ride" to find the right dosage and right med. Sometimes I felt like she was being used as a Guinea Pig.
Make notes about her symptoms. Time of day it occurs more, the frequency, any other behavior concerns, etc... So when you talk to dr. you can be more precise to better help Dr. understand.
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Her blood sugar is ok. I don't know how you distinguish if symptoms are a side effect of a medication or a result of something else that's going on, i.e. dehydration. Hopefully the doctor will know! Thanks for the good suggestions.
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Medications can cause individuals to hear or see things that are not there. Medication, before and after they are available to be prescribed, are monitored for these side effects and many more. If a medication can cause this side effect, it is noted in the consumer information sheets provided with prescriptions. Side effects are grouped into broad classes such as ‘frequently seen’ or ‘rarely seen’. However an individual’s general and mental health condition greatly affects the individual’s response to any medication. Also, other medications being used as well hydration may alter the side effects and how severe that side effect might be. Any serious side effect should be discussed with the prescriber, hearing and seeing things that aren't there should be promptly discussed with the prescriber.
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Thank you for your response. The doctor discontinued her Toprol over a week ago and did not prescribe a replacement. Her blood pressure has been good and she is feeling better, but she still hears music that no one else hears. I will discuss this with him at the next visit, but I'm guessing that he'll again refer her to a geriatric psychiatrist, and she'll again refuse. I guess I need to determine at what point she can no longer make those kinds of decisions.
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My mother-inlaw is going the same but she only does this on occasions, she think someone is in there home in my father-inlaws bedroom, she thinks they only come at night, and it is the neighbor, with another man..she has been taken off the medication she was on that they think is causing..didn't work, she 65 and my father-inlaw has had enough..help
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Could be Lewey Body Dementia....
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Rhonda, is this a case of hallucinations, or of delusions? Does she actually see people in the house, or does she believe they are there, without claiming to see them? One thing that can cause these kinds of problems is a urinary tract infection. Is this a possibility? If these continue with no explanation, perhaps it is time to consider a full geriatric examination.

Does she have any other behaviors that might indicate dementia?

I can understand that FIL has had enough. I hope that he can be patient and supportive. It is extremely unlikely that MIL is doing this on purpose.
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It is worth mentioning too that many times, a patient has lost some weight, which can influence how many medications affect them. If your loved one has lost or gained more than 10 pounds, be sure the doctor is aware. It might make a big difference! Same with new or discontinued medications as thee are many interactions.
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When my mother finally let me have a little bit of control and go to the doctor with her, i took with me a list of the 15 medications that her two doctors had her on, and 18 pages of the various possible interactions between them. One was potentially fatal, and several were causing the problems that they were attempting to medicate! Ambien was causing her to see, hear, and believe things that were not there and were not true. She was also on two anti anxiety drugs; Depakote; Prozac; and Verapamil, amongst others. We took her off of the Ambien, Prozac, two anti anxiety medications, and cut the Depakote in half. The doctor did give her Trazadone at night for sleep. Since then my mother's mind has cleared considerably, she shakes MUCH less, and she is now able to stand and walk more stably, (she had fallen over half a dozen times in the last year, breaking an ankle and a tibia).

Do stay on top of the medications! My good friend found me a website, that allows me to type in all her meds and then tells me of the side effects and possible interactions. Then I talk with my mother's doctors and pharmacists about them.
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Nothing espeically new to add with what's already been shared. My Mom is 94 and has had insomnia and hallucinations from tylenol pm and bactrim (anitbiotic for mrsa staff). Since these are not the most common side effects for these meds, they were not communicated prior to taking. Now, anything the Dr.'s talk about....I go on line to check what the side effects are, and, what just us regular people have experienced as well. Once I've researched and ask the Dr.about them, they have not prescribed those to her. It's really hard to know the right thing to do. You know your Mom better than anyone, so don't doubt yourself. I've put alot of things together, after the fact, that I wish I would have acted on quicker. It's definitely a learning process and sometimes you have to go with your gut. You are your Mom's best advocate!! Hugs to you!!
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My mother is suffering from paranoia, convinced the "pest" across the street is doing things that we know are not happening. She's very afraid, keeps her blinds down, piles pillows when she sits on the couch so he can't "see" her, hears his voice outside her home, etc. She gets very angry if I appear not to believe what she's telling me, even though I learned not to argue with her about it long ago. What can or should I do???
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Paramoia can be a part of many conditions. Mom should be seen first by her primary care provider and possibly get a referal to a specialist. Have there been other odd behaviors lately? Memory problems? Go prepared with a list of any other unusual behaviors or symptoms.
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My mother isn't on any medications. I have alerted her family doctor and we've gone to see the doctor regarding these paranoia episodes but the doctor says as long as she's not a danger to herself or to anyone else, there's nothing that can be done. The doctor suggested an anti-anxiety medication but she won't take anything.
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would hydrocodine and xanax make a 68 year old think that people are out to harm him and hear conversations that never took place.He has been on these meds for more than five years not to mention other medicine for HBP and a few others.
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It's possible. There is a lovely dotcom called drugs, I use it all the time. They have a place where you can add in all the medications that you or a loved one is on and it will tell you all the side effects that might present.
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My aunt, age 83, was good health, lived alone but developed bad cellutis on her legs. Son took her to the hospital and she was treated only 3 days with IV anitbotics and sent to a rehab/acute home. Went to see her, she was always sleeping, ask what meds. took none. Not even anymore antibotics, I felt she should had move IV, since when you take form, you take for 7 days. Concern about her treatment. I was told to talke to her son about her treatment, he never contacted me. Soon, she took her to another local hospital which she seemed to be aware and better, talked great, had a CAT scan, was told she could not stay anymore because nothing was wrong, she just needed PT to walk. Son took her to another very new rehab/acute home local. He never contact us about her going. SHe has only 1 sister living, she is confined to a wheelchair due to a fall and broken hip. She is now afraid to try and walk, she is 89. so she lives with me and my family local to. I want to see her and again, she was sleeping. I questioned the nurse, she said to talk to her son, her has power of attorney. She said she was not taking any meds but would double check and come back to room. She never did. I continue to visit my aunt, I would talk to her to get her to wake up. She new me and my family, was hunger. I would bring her different fruit, she enjoyed and ate all of it. SHe wanted fudge which I brought, even fresh coffee, she looked too. I would call to check on her but she would not answer the phone in the room. I would call the nurse station for them to give her the phone. They would say, she is sleepiing. Again, her son took her back to the last hospital. I found out a nd went to see here, the nurse thought I was her daughter. Said she was dehydrated and had IV and wanted to let her sleep thru the night. I went back next day and she was sitting on a very large rehab chair and was happy to see me. She wanted some gum for her bad breathe, so I went to gift shop and purchase it. I also went to cafe and found some rice pudding. She inhaled the pudding in seconds and wanted the gum after. I stayed for over 8 hours with her and she was find. She did talk about flowers in the room, which were her roommates. She thought they were her's. I said I would bring her some from my garden and she smiled. SHe looked great. I was concern about one day sleeping alot and next time fine. Could this be meds doing this. I feel the nurses didn't help her eat the meals or give her enough water to drink in all these places. I also think she was getting confused being moved from May 22, 2016 to July 22, 2016 to all these places. She was scared too. Well, July 21, 2016, my mother called as always, 3or 4x a day to also check on her and was told to talk to her son in each of these different locations. We did call him and always got a answering machine. He only returned the call, once, saying I should not bother the nurses because, his mom needs rehab and he doesn't want us to interfere. I always went over in the afternoon when it was finished to visit. He was sharp too. On July 21, he called and said, his mom was starting to talk to relatives that are dead and he felt she was dying and needed morphine to keep her quiet. Well, July 22, she died. My mom and I are very upset because she was to be treated for cellutis on her legs which my mother had and was in the hospital for IV for 6 weeks for treatment but OK now. And her son would not try to get 2nd option. I told him when he called about PT, stay away, to get another doctor and option. He just would not listen. It is like he had his mind made up. My aunt ask me the 3 days before her dead, to get any coats to keep for her since last winter it was coat and she needs a modern style and she knew I had some I was going to donate to charity. What do you think happened? I think he did not want to bring her home and have to take care of her. He was married, both retired and love to travel with no kids. Her daughter lived 1 block away also retired with grown son and grandson about 10 miles away but she like to go on crusies with friends. Another son also retired and married loves to go to the local island and boatting, babysits his 4 grandkids so he doesn't have alot of free time. BUt this was there mother and my aunt. I cann' t believe she was in her last stages of dead. Her youngest son works and remarried. he was a son who lived with her and he finished local college. He helped her alot, he was like her son. He really is in shock now. What happened? What do you think? THe hospital floor is was on, was a training floor. They were not expereince and used her to practice. She is no longer around and I feel wrong choices were made. Now it is too late. Please let me know what happened?
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I also forgot to mention, her son called to let us know she died from sepsis, I dont' believe it. He said her organs were shutted down and she had a bad infection. What could they treat it? SHe was enough hospitals.
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Between caring for my mother and later my husband's aunt, we ran into several instances of hallucinations but tried to keep the situations in perspective for the sake of all concerned. Unless those "visions" are putting the patient in danger, why fight it? We tried to encourage them to just enjoy the reports of cute little lizards or kittens on the walls. When asked whether I could see the beautiful "aurora" in the sky, I could honestly answer "No, but I'm glad you can." I guess some people feel compelled to "set him/her straight" about what they think they are seeing, but enjoying the mental show is probably better for them than watching TV.
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Very possible. Mental reactions to medications is not unusual especially for elderly people who often don't metabolize them well. I always suggest the the first thing people have checked when mental or cognitive issues are noted are the medications. Just doing this can eliminate any number of suspicious cases of dementia. One example would be incontinence meds but there are many others.
Take care,
Carol
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