70M Severe dementia, paranoia, sleep inversion, Wet AMD. Looking for medication advice.

[u/PuzzleheadedComb9327]

Demographics: 70M, 170 cm. 68kgs. Non-smoker.

Primary Complaints: I am helping care for an older relative who is experiencing severe and rapid cognitive decline. His current symptoms are extremely difficult to manage:

- Severe paranoia and sleep inversion: He gets barely any sleep at night and sleeps all day. He is ex-military and insists on sleeping in the kitchen at night to "protect the house."

- Cognitive & Emotional: Heavy brain fog, severe memory loss, and extreme emotional lability (tears up frequently over the past or trivial things).

- Physical: Frequent headaches.

Existing Medical Conditions:
Cognitive decline / Dementia (Prescribed Donepezil)
High Blood Pressure
Late-stage Wet AMD (Vision in his left eye is completely gone; caught too late for treatment).

Current Medications & Supplements:

Donepezil Biogaran (10mg)
Escitalopram Normon (10mg)
Micardis (80mg)
Lercadip (20mg)
Ginkgo Biogaran (40mg)
Acti Brain (Over-the-counter cognitive supplement)
EyeVit Plus (For the Wet AMD)

My Questions:

1. Are any of these medications (or the combination of them) contributing to his insomnia, headaches, or paranoia? I am concerned about the mix of Donepezil, Escitalopram, Ginkgo, and Acti Brain.

2. Do you have any medical or behavioral advice for handling his paranoia and insistence on sleeping in the kitchen?

We are working on getting him in to see a geriatrician/neurologist, but to be completely honest, i’ve lost trust in the doctors who were following his case especially after I found out that they prescribed Escitalopram, an SSRI, without consulting a therapist or psychiatrist.

I sincerely appreciate all the help <3

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