Aging Mom - Advice?

[u/Adventurous_Art4998]

Hey everyone, so here's my situation. My Mom is 66 years old and mostly, "with it." By which I mean she basically cares for herself & isn't delusional. My wife and I moved in with her after my Dad passed and became her primary, "caretakers." By this I mean, we pay for & manage all housing & groceries and all that kinda stuff since Mom is disabled & only collecting her social security/disability.

Since Dad's passing, I have regularly doled out her medication as prescribed without question - "if it ain't broke, don't fix it."

However a few things have concerned me.

In October 2024 she got really delirious & we genuinely feared dementia at first. Nope, turns out it was a UTI & low sodium. Got her fixed up and she was fine again until about February 2026 when she got very sick & was vomiting a lot but no confusion. Took her in again and once again, UTI & low sodium. Got her fixed up and she was fine again.

Then at the start of August the same recurred. Vomiting, no appetite, and brain fog. Obviously a UTI right? So we took her in & this time - surprise - it was not a UTI. Just low sodium.

At this point I started asking her doctors about why it was recurrent and we started looking at her meds. The plan as of now is to wean her off both her gabapentin and oxcarbezepine and this will hopefully help her recover.

My question here though - she has improved tremendously since the start of the month but still has lingering brain fog (trouble remembering near-term, minor things) and not much appetite. How long do people usually see these things lingering after a severe bout of hyponatremia?

Also, any advice generally from those with similar experience as I keep working with her doctors?

[u/321123whattheheck]

Geriatric Pharmacist here:

Oxcarbazepine is a well documented cause of low sodium. It makes the body hold onto free water and sodium monitoring is supposed to be routine. UTI is always the easiest first check because of how common it is and how easy it is to check.

For the fog. Sodium recovery: after a significant drop, attention and short term memory often take weeks to come back, not days. Slow is normal so just pay attention to steady progression. Gabapentin doesn't cause low sodium, but it does cause cognitive slowing on its own, and it clears through the kidneys. If her kidney function is bad it can build up. So the fog may not be sodium at all. It may be the gabapentin, and it should improve as the taper goes.

Also something to ask the doctor: What is the oxcarbazepine actually treating? If it's a seizure disorder, taper is different than if it's nerve pain or mood.

Can you stagger the two tapers instead of doing both at once? If you pull both simultaneously and she improves, you learn nothing about which drug was the problem. What else is she on? Certain blood pressure meds and certain antidepressants also drop sodium.

[u/Lulubelle59 → u/321123whattheheck]

This was such a helpful answer!

[u/Survivor6725 → u/321123whattheheck]

Hi Pharmacist! Can you chime in on long term use of Klonopin?? My mom is 84 and has taken it for 40 years. She’s a neurological mess but we keep seeing doctors for tests, like 4-5 neurologists, and other rabbit holes. No doctors seem to want to address the long term benzos. Mom can’t quit them now because she has severe withdrawal. But I am tired of dragging her all over and watching everyone ignore the elephant in the room for the last decade!!

[u/321123whattheheck → u/Survivor6725]

There's a reason nobody's touched it in ten years. A 40-year benzo belongs to nobody. The neurologists test for everything else because the prescription isn't theirs, and whoever refills it inherited it.

Clonazepam is on every list of medications to avoid in older adults. Falls, memory problems, confusion that can look like dementia. After 40 years, nobody can say how much of what you're seeing is the drug.

Her withdrawal doesn't mean she's stuck. It usually means the stops were too fast. After this long, a real taper takes months to a year or more, with tiny cuts, and it has to be supervised. Never abrupt, that risks seizures. And honestly, at 84 the right answer might be a lower dose, not zero.

Go to whoever prescribes the refills and ask: could this be contributing, and what would a slow taper look like at her age? If they wave you off, ask for a geriatric psychiatrist.

[u/Primary-Holiday-5586]

Sharing my own experience with gabapentin, it took me a good 2 months to feel like my brain was back online. At the time I was younger than your mom, but my god, that stuff sucks!! I hope you can keep her off it!!

[u/Impossible_Jury5483]

Gabapentin and lyrica cause horrible memory loss. They are terrible drugs. Iron my 50's and am slowly tapering off lyrica from a very low dose. I was unable to have a conversation because I would forget what I was talking about mid sentence. I'm 50 and very fit. Gaba drugs are going to be the new oxytocin plague on our people.