Advice needed regarding antidepressants!

CS 63

My DH with EOAD and FTD has been on Cipralex since Feb.  Started at a low dose and doubled it in April as I didn't feel it was helping much.  We started the med because he was having suicidal thoughts and many 'down' days.  He still gets stuck easily, especially with losing his license and not being able to drive his motorcycle.  Another huge issue for me is his inability to socialize with our daughters and their families.  We used to have Sunday suppers at our house every week and they were always very important to my DH.   He is no longer comfortable (for the past couple of years) with having them here, especially our 2 grandaughters, aged 2 and 4.  I miss seeing my children, their spouses and grandchildren.  This journey would certainly be easier if he was comfortable having them here.  My sister, who is a nurse, feels that we should be able to find an antidepressant that will relax him enough so that he will be able to tolerate and maybe even enjoy family functions again.  Has anyone out there had a similar experience and found a medication that would help?

Stuck in the middle

I took Zoloft for 20 years, or its generic equivalent.  It worked well for me, until it didn't, and the generic is not expensive.

Any time a doctor prescribes a medication, and it doesn't work, I tell the doctor so she can try something else.  She doesn't know it didn't work until I tell her.

I don't know if this will help the socialization difficulty or not.  Have you tried smaller groups, like #1 daughter one week and #2 daughter the next?

dayn2nite2

He needs a geriatric psychiatrist.  And trying different drugs is a process.  Might take a few months for each one to be tried, dose raised, and discarded.  Please do not use a PCP for this kind of depression, he needs a psychiatrist.

People with dementia often find children irritating.  If you want to see your grandchildren, you may have to pay someone to stay with him while you go to them.  

Having Sunday dinner at your house is probably done.  You need to keep his agitation down to a minimum, especially since he’s so depressed.

If you’re getting the feeling that your needs come second to the spouse with dementia, I can verify that you are probably correct.

storycrafter

You mentioned FTD. My husband was diagnosed with it several years ago. In his case it's been one of slow decline. Earlier on when it finally reached a crisis point, he was suicidal and had very disruptive bi-polar behavior, deep depression alternating with manic impulsive, disruptive times.

In our case, the PCP immediately prescribed Seroquel and referred him to a psychiatrist. With the help of the psychiatrist it took several weeks to work up to a therapeutic dose of 300 mgs Seroquel, but once he did, it turned both our lives around, returning a measure of quality of life.

Different drugs work differently for different people and this may not be the right drug for others. It takes trial and patience, but it's worth it to find something helpful for your loved one. Keep at it until he gets the help he needs. For us it was Seroquel and Buproprion that made a difference; they've been a blessing for a situation that had become impossible. Best wishes to you.

Ernie123

I was going to suggest exactly what Dayn2nite2 posted. Geriatric Psychiatrist. As changes occur in the future you need a specialist who can adjust meds as required. My DW has benefited greatly from proper assessment and treatment. She now lives in care but her severe delusions, anxiety and paranoia are now managed very well and she is calm and content with few upsets. I attribute her new quality of life to the attention of an experienced Geriatric Psychiatrist. Her chart is monitored remotely by the Geriatric Psychiatrist’s nurse and every few months adjustments are made if required.

shardy

Dh also was diagnosed with EOAD and FTD. He started on citalopram 5 or so years ago, increasing every 6 months or so till He was maxed. We then added a low dose of quetiapine and have been increasing as needed, at first every 6 months or so, now around every 4 months.

I couldn't go without visits from my children and grandchildren.our answer was to give him a place where he could go to be alone while they are here if needed. They still come and sometimes he interacts and sometimes he prefers to be alone.

harshedbuzz

Team Geripsych.

Geriatric psychiatrists are the specialists in the area of psychoactive medications so I would do whatever it takes to have him seen by one. Dad had mixed dementia; the SSRI he'd taken for years was not enough to take the edge off of his anxiety and agitation, so his doc added an atypical antipsychotic which we increased when his hallucinations and delusions began to upset him. 

That said, as the disease progressed I found dad enjoyed gatherings and celebrations less and less. In the early stages of the disease we threw a huge 80th birthday party for him which was wildly successful. Three years later, we took him out for dinner as a table of six (including his beloved brother) at a quiet outdoor restaurant and he did well. Two months later we tried a formerly favorite steakhouse for my parents' anniversary as six with 2 adult grands in place of his brother- he couldn't deal with the menu, the busyness and complained bitterly that I had included my son and niece instead of his brother. We thought maybe Thanksgiving would be simpler at his house and he was OK so long as we (7 this time) were all in the kitchen doing food prep. He lasted 15 minutes at the table before grumbling and toddling off to lie on his sofa. We repeated it at Christmas for brunch and he was just angry and insulting from the get go. FTR- he was well medicated by this time.

In your shoes, I would bring in a HHA and visit with family at their homes. 

HB

Rescue mom

My DH with Alzheimer’s used to enjoy parties and family get-together. He does not anymore, even with meds that treat his anxiety and depression. Dementia changes most things. Harshedbuzz said it.

My DH is extremely uncomfortable, and does not willingly engage with,  anyone, even family, for more than a few minutes. It’s a fairly common symptom, from what I’ve seen in support groups and heard from specialists. I had to find ways to see family without him being involved—I go there without him,  or by “allowing” him to be elsewhere in the house when they were here.

CS 63

Thank you to all who responded!  We live in Canada so our PCP's are called General Practitioners or GPs.   She suggested a Geriatric Psychiatrist but unfortunately my husband, who has just had his 56th birthday, is too young.  We are quite frustrated that alot of the services available for dementia/Alzheimer's  patients are not available for people as young as my husband. In my mind it's the disease and not the age that should dictate care.  Fortunately, our daughters both live close so we do have short, quick visits.  

I am in the progress of setting up some respite care.  We are entitled to 5 hours a week, paid by the government plan.  We tried a male for a few weeks but it made my DH feel stupid and uncomfortable to do things and make conversation with someone he didn't know or have anything in common with.  We are trying a female more our age and I am taking things slowly.  We have had 3 short visits so far with me staying and my DH is enjoying the visits.  i am hoping that I will be able to start leaving for increasingly longer periods of time so that I can visit with my Mother, daughters and grandaughters for longer periods of time.  I think I've come to the  realization that family get togethers as we once knew them are over.  

DH has recently started having seizures and is now on new antiseizure meds, Keppra.  I have been able to have my daughters come to stay with him while I run some errands under the guise of him needing somebody here in case he has another seizure.  I can tell he'd rather not have somebody here but really doesn't want to be alone if he has another seizure.  The CT scan he recently had at the hospital had the radiologist thinking that what he saw wasn't normal progression of AD.  So he's suggested an MRI and referral to a neurologist.  The MRI is scheduled for Aug 12, and who knows when for the neurologist.   The ER doctor said it could be up to 8 months, ugh!  In the meantime, I will continue to try to get out for some quality time with the rest of my family.

aod326

Hi CS. I share your frustrations regarding treatment for younger patients -my DH was 59 when he was finally diagnosed. DH's neurologist said we needed to find a geriatric psychiatrist, but almost all refused to see him, because of his age. After trying with many different ones to get an appointment, I finally persuaded one. Although he did speak to DH's neurologist first, which I see won't work for you.

On a different note, although it sounds like he would benefit from different meds, the behaviors you describe are, sadly, typical for dementia patients. What would be depression talking for non-dementia patients, can be normal behavior for dementia patients. One big example is the appearance of lack of interest/motivation. That would be a big clue, but with dementia patients it's really just a part of the disease progression.

Best of luck on this difficult journey.

wiiliscreg

My friend is pregnant and she is still taking her AD. Do you think it is ok to do that?

Ed1937

Wiiliscreg, That question needs to be addressed by her doctor. And soon!

BTW, this thread is two years old.

Brigv

wiiliscreg wrote:

My friend is pregnant and she is still taking her AD. Do you think it is ok to do that?

Sometimes antidepressants are an option during pregnancy. If you know the name of the pills, you can look for the description here https://www.canadapharmacy.com/ and read it. A decision is based on the balance between risks and benefits. The biggest concern is typically the risk of birth defects from exposure to antidepressants. But of course, this decision should be taken by a doctor.  

jfkoc

I think you are asking about Lexapro. I was  unableto take it. It made me extremely anxious. Do chat with the doctor about trying something else.

Pipsmom

My DH has a hard time with ANY gatherings of more than two. His cognitive abilities make it hard to keep up with the conversation. This is part of his dementia. He doesn’t mind getting together but doesn’t participate in any conversation. His daughter calls regularly because she lives far away. He will answer the phone, put in on speaker and then just ‘listen.’ But I can tell he can’t follow.