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Frequently salivation and mobility issue
Hi all.Iam posting this query on behalf of my mother who is 79 years old.She is a very active person by nature but sadly 2.5 months ago she was suddenly diagnosed with psychosis out of nk prior history.She has been on medications since then.she has a prior thyroid history for which she is taking medicines daily.Also bp medicine once a day.Now the issue is for the past 15 20 days she is facing increased salivation issue.She also doesn't have denture to eat hence only mashed food is given to her.She has appetite other wise. Her walking is ok but she at times has difficulty getting up and requires support.Can anyone throw light on what's the issue and what needs to be done?
Answers (21)
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Likely from the anti-psychotic medications which for some can cause what we call ‘Medication induced Parkinson’s’.
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The increase in salivation and difficulty in moving could be due to the medicines prescribed for the psychosis.As she has thyroid issues,a thyroid function tests,her vitamin dliver function tests are required.A review with her treating psychiatrist may help,changing the present medicines
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Hello. I have reviewed the concerns regarding your mother's increased salivation and changes in her mobility.
At 79, while she remains active, the sudden onset of these symptoms following a change in her psychiatric medication requires careful evaluation.
1. Potential Medication Side Effects
Drug-Induced Symptoms: Many antipsychotic medications can cause "extrapyramidal symptoms." This often includes excessive drooling (salivation) and muscle stiffness, which may explain why she is having difficulty getting up and requires support.
Sialorrhea (Excessive Salivation): This is a common side effect of specific psychiatric drugs. It occurs because the medication can affect the swallowing reflex or increase saliva production.
2. Mobility and Safety
Muscle Stiffness: If the medication is causing stiffness, it increases her risk of falls. The fact that she now needs support to stand is a significant change in her "active" baseline.
Next Steps
Immediate Review: You must consult her Psychiatrist or a Neurologist as soon as possible. Do not stop any medications abruptly, but the doctor may need to adjust the dosage or switch to a different medication with a lower side-effect profile.
Physical Assessment: A doctor needs to check her for "cogwheel rigidity" or other signs of drug-induced parkinsonism.
Supportive Care: Ensure she has assistance when standing to prevent falls until her medication is adjusted.
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Please consult a Dentist or an ENT surgeon in your area for a physical examination. There can be some dental problem or oral pathology which may lead to excessive salivation.
I am not aware of any medicine which causes excessive salivation.
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In an elderly patient (79F) recently started on antipsychotic medications, the sudden onset of increased salivation (Sialorrhea) and difficulty in rising from a seated position (Mobility issues) is highly suggestive of Drug-Induced Parkinsonism. This is a common side effect of certain psychiatric drugs that block dopamine receptors. While the medications are necessary to manage psychosis, in the elderly, they can sometimes cause muscle stiffness and excess saliva production. It is important to differentiate this from a new neurological issue or a progression of her existing thyroid/BP conditions
Next Steps
step. Consult her Psychiatrist immediately to review the dosage or type of antipsychotic. They may need to switch to a 'lower-potency' or 'atypical' medication that has a lower risk of causing movement issues in seniors.
Neurological Assessment: A physical exam is needed to check for 'cogwheel rigidity' or tremors, which would confirm drug-induced symptoms.
Review Thyroid & BP Meds: Ensure that her thyroid levels (TSH) and blood pressure are stable, as imbalances in these can also contribute to muscle weakness and fatigue in the elderly.
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This sudden onset may be daunting. Given the age and the details provided to me this excessive salivation ( sialorrhea) and difficulty in getting up could be a side-effect of the medication for psychosis. In medical jargon these could be Extrapyramidal Symptoms.
However, I hope she has gone through her blood work to assess her Thyroid Profile, Electrolytes, HBa1C to rule out that there is no imbalance there.
Next Steps
Please do a review with her treating doctors. A review will give clarity on whether the medications for her new medical condition ( Psychosis) as well on-going ones for Thyroid & Hypertension are adequate and not aggressive or inadequate.
Health Tips
ensure that the saliva doesn't pool in her mouth to increase the risk of aspiration, especially in view of lack of dentures.
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