Mom has vascular dementia and Alzheimer's. Dad has mobility issues. They moved to assisted living two weeks ago. Mom takes memantine, Aricept, and began taking Seroquel last week (dosage was upped today to 25mg twice daily from 25mg once daily). She is still yelling, angry, wants to leave, feels imprisoned, wants to drive her own car (which is not there). These behaviors began pre-ALF, but we were hoping being in ALF would provide her with activities, thus distracting her from constantly berating the family. The Dr. at the ALF has suggested taking away the Aricept, to move her out of the stage she is in. A family member, who is an M.D. specializing in geriatrics has suggested Respiradone instead of Seroquel (he has not examined my mom). I am aware that Respiradone and Seroquel are Black Box Labeled for dementia and the risks of both. Please let me know if you have experienced these issues and what medications or withholding of medications has been successful. Thank you.
You could get 100 responses here and none of them may resemble your future observations. You may even be persuaded to push for what turns out to be the wrong choice, just by seeing others' successes or horror stories.
Best to go with docs' advice.
Thanks for starting this thread, mrmoose, it’s helping me too so I can be more informed when speaking to mom’s doctors about what they suggest. She just got kicked out of an MC after 40 days (and investment of her money and my time & effort) with supposed oversight of how her current meds were working. They weren’t.
My LO was taking an antidepressant for several months BEFORE her admittance, and within a couple months, a visit with a very skilled psychiatric consultant brought about a change in medications that has given her even more peace and relief from anxiety.
Our frequent visits are much more joyful than earlier on, and she is less driven by her previous desire to “go home”.
As dementia increases, every attempt to give meds seems to cause more anxiety, both for the person with dementia and for those administering it, whether it's a family member or an aide. We now has a prescribed B vitamin to be used as a placebo in place of the anti-anxiety meds, and it seems to work as well, that is, not always 100% but seems helpful for the person.
Most dementia care experts seem to say, the fewer drugs the better. Read Dr. Tia Powell's wonderful Dementia Reimagined. Or Dr. Peter Whitehouse, who helped develop on of the early dementia drugs at Johns Hopkins and now encourages using as little in the way of any meds as we can.
(Unless the Vatican really did help your mom, which is indeed wonderful.) 😀
Autocorrect is a blessing and a curse!
We could understand her, we had fun, we danced and sang and did yard work and whistled and marched around the yard to John Phillip Sousa music.
Risperidone did that for us.
Best of luck to you and your family ... the anger is so hard to deal with. God Bless!
Susan
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Quetiapine fumarate is not approved for the treatment of patients with dementia-related psychosis or for patients under 10 years of age. So you see it's not approved for such use but doctors give it anyway?!!!! Well I had the fortunate opportunity to send my husband to a geriatric 55+ Inpatient tharapy and Rehab. They try to wean them off certain meds and replace with others until they figure out what stabilizes their mood. I learned there is a difference in mood stabilizer and anti-psychotic meds. They also must figure out the proper dosing for each patient. It takes time and some trial and error. But in five weeks he was his old self again. I could not believe how much better he was after being at the place. I also used DRUGS.COM ALL THE TIME. I made sure I knew what he was taking and why, possible side effects etc. In Texas, every six months the state law requires the Nursing Home stop giving psychotropic drugs to see how the patient does without the medication. The law is to protect the patient from becoming over medicated so the staff can easily manage them which used to happen a lot. BUT, they don't tell you this or when they do it. There is no "weaning them off" either. Just stop it cold turkey. I finally knew why he would be so normal and then "BOOM"!! He was psychotic again. Luckily my neighbor was a pharmacist up
at husbands home and I finally got her to tell me why the home kept taking him off important medications. The law may be well meaning but it only hurt the patient and close family members. Too
much of a given drug can cause a drop in sodium levels in the blood stream and your loved one starts having seizures because low sodium levels causes the brain to seize. It's terrible to watch this happen. So I took my husband to the ER every time until they went away. We MUST ADVOCATE FOR OUR OWN FAMILY MEMBERS. NO ONE ELSE DO YOU WW away. But then they return AND I WOULD CHECK AND
I ALSO RECOMMEND THE Bar KNOWN As THE authority on all dementia
"THE 36-HIUR DAY" by Nancy Mace and Peter Rabins.
This book was given to me by my sister who works for the Alzheimer's Association and it it a treasure full of great tips, advice and what to do's!;
The dosages are fluid, and she’s seen by the psychiatric PA once or twice a month.
She’s still not easy to manage, but much more herself, more comfortable, and better sleep/wake cycles.
Hope this is helpful to someone.
I knew this would be bad for my sister-being isolated and not understanding what was going on or why. I was hesitant to do what they wanted until the third trip to ER, I felt we were never going to find a solution going to the ER every other week. I finally agree to in hospital psychiatric/medical evaluation. three weeks later she was finally released after being in restraints for all but 5 days at the end before current community would take her with anger issues and all. In spite of hospital stay and new facility-I think my sister did well considering.-except facility assessment person was doing her in person assessment of my sister on the worst day ever-spitting, biting, kicking hospital staff-we were told facility would only accept her at maximum care at 9K a month. We had been told at other communities potential placement of people with "behaviors" is not acceptable. So we were stuck going with the only place we could find-which has several angry people-women and men in the same area. Anyway-hospital evaluation removed the Aricept, the Parkinson's medication, Sinemet, and added Zyprexa instead. She continues to take Prozac for depression and Aricept. BP meds.
Facility tells me that my sister cries most days-according to them-uncontrollably-I have never seen this myself. Whimpering for a minute or so but that is it. After multiple complaints of crying from staff, Facility increased Prozac to attempt to address crying most days-this has not helped and they since reduced the dose.
After a few months of the Zyprexa my sister was horribly bent over and now in a wheel chair. Dr. agrees to reduce the Zyprexa and now my sister has much better posture. Dr. gave me a list of meds they do not like/want to use and Zyprexa was on the list. But anger now seems to be back in the mix. I take my sister to outside neurology doctor who is willing to try something else but will take time to figure out a good balance. Crossing my fingers we do not end up back in the hospital.
We have now been declined new placement at other facility at least 3 times due to crying, and now a report on her nursing facility notes that she cussed at staff and residents. Now we have a behavior felony on her record-We are stuck in this horrible place where my sister has been injured 4 times, and unclean on a number of other occasions, and had a horrible case of scabies, before I brought to the attention of staff. Sister has lost 20 pounds since living in this place-also food is nasty there.
I have been told numerous times since there is no cure for this disease all they can do is attempt to treat the symptoms-trying to minimize drug side effects and making people sleep all the time. Sorry but I do not have any miracles to offer on medications or treatments for anger issues that don't screw up other things at the same time.
Hope you find the right balance to help with mom. Best wishes.
Mom started taking zyprexa in January and had a profound loss of ability to lift and move legs, and stand upright. Someone mentioned the same above with that drug. Just an observation.