My grandmother has been using the Exelon patch (4.6mg) for almost four years now. I just had to move her to a nursing home for (hopefully) short-term rehab after she cracked her knee cap. The nursing home is forcing us to use their treating physician and immediately upon her admission he made changes to her meds, including her psych meds. She quickly fell into a deep depression saying she was "ready to die," and refusing to eat or drink, etc. (I'm sure that the depression was not caused solely by the doctor's changes in meds, but also by being in the nursing home, the onset of additional pain from her knee injury, and the loss of mobility.) She was admitted to an inpatient geropsychiatric unit at the local hospital for 11 days where the medical director is her long-time psychiatrist. By the time she returned to the nursing home she was upbeat again and making progress in PT. Just a few days ago the nursing home physician stopped her Exelon patch and switched her to Exelon pill (1.5mg) once a day. In 30 days he will increase the dose to one 3mg pill once a day. Today my grandmother is very depressed, saying that everything is closing in on her and that she "can't deal anymore." I suspect that the reduced dose of Exelon may be causing this recent onset of depression. Has anyone had their Exelon reduced and/or switched from patch to pill form? Did you experience any problems as a result? Thanks for your help, everyone