I don't think of having OH as the body wearing out. OH can be a disabling symptom, and lead to poor quality of life, but it is a symptom that can be managed, especially by a cardiologist who knows what he/she is doing. Keep giving that water!

My husand (who has LBD) tolerates the Exelon patch well, but my best friend's mother reacted very similarly to what you describe when they tried her on the 4.6 patch. She has vascular dementia, and got quite upset and hallucinated on the patch. I believe they only left her on it 2 days. Hope this helps.

My husband has been on the Exelon patch for about two years. Initially, there was some cognitive improvement and a significant reduction in agitation and angry outbursts. It never had any effect on his delusions, illusions or hallucinations. I often wonder if it's worth continuing, but it would seem prudent, in the absence of adverse effects, to remain on the Exelon for the duration.

He was in a SNF last winter for rehab after hospitalization for an acute illness. A psychologist who saw him briefly took him off the Exelon and put him on Risperdal. I think it nearly killed him--he could barely get out of bed after a couple of weeks. After some research, I found two British studies published in medical journals that warned that Risperdal can produce very adverse effects in PD and PD-related illnesses. I immediately had it discontinued, and he improved by the following day! Then I had him put back on Exelon.

Mockturtle, Frank was on Exelon for over 2 yrs and it didn't seem to be helping any longer. His Dr. stopped the Exelon and a few weeks later started him on Namemda, gradually up to 10mg 2xdaily. I've been told that once on Exelon, he should continue for good but we hit the donut hole each June and $200. a month is a lot,for something that doesn't seem to help. He had a 10 day stay at a rehab in Nov. and seems to have gone downhill ever since. We have a Dr appoint at the end of the month, I'm hoping there will be something he can take to help a bit. He doesn't seem to understand what's going on and can't express what he wants or doesn't want.

What a start to the New year.

Take Care,
Gerry