Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Drug interactions

Forum: Neurology Forum
Topic: AIDS


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.


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.



This Forum's Doctors
Craig Brooker
Cleveland Clinic
Lama Chahine, MD
Cleveland Clinic
Esteban Cheng-Ching, MD
Cleveland Clinic
Cleveland Clinic, MD
Cleveland Clinic
Joanna Fong, MD
Cleveland Clinic
Expert Activity
World's longest living person passe...
Dec 02 by Enoch Choi, MD
How To Beat Insomnia Without Medica...
Dec 01 by Steven Y Park, MD
Attention All Mouth Breathers: 5 Im...
Dec 01 by Steven Y Park, MD

[Neurology Forum]    [Neurology Forum Archives]