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I am 82m and has been suffering from senile dementia and insomnia. I was given (donepezil 5 mg + memantine 5 mg) for dementia. After taking the medicine last one month my serum sodium level fell below 125 meq/l. To control hyponatremia, doctor prescribed me to take tolvaptan 15 mg along with 05 g salt capsule daily with a water restriction of max 1200 ml per day. Even after 30 days of taking the above medicine, my serum sodium level is still 133 meq/l which is below the normal ref value 138 - 148. Should I continue tolvaptan 15 mg + 5 g salt cap + water restriction for more days or increase the dose of tolvaptan to 30 mg? Earlier also I had to stop donepezil due to induced hyponatremia. Please advice if I need to stop dementia medicines completely or not.


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