Meds(7)

LeBret

We seem to be having a whole lot of problems finding the right meds for my wife [She has early on-set, late mid-level Alzheimer's]. Either they do nothing, or they make her physically sick, or they turn her into something like a drunken zombie. Anybody else have this problem?

jmlarue

Personal opinion - it's always a crap shoot. Some folks with dementia do okay on the common psych drugs. Some (like my DH) do not. We've found one (Prazosin) that helps with his sundowner agitation, anger, and aggression, but it's only moderately effective. I'm finding that the dosage has to be increased about every 3 months to remain even 50% effective. I dread the day he's at max dosage and the Geri-Psych has to switch him to something new. If there's a nasty side effect to any drug, I've come to expect my DH will suffer it - which means I suffer it, too. I've turned to trying medical marijuana. The CBD oil alone had no noticeable effect over a 3 month trial. No harm, no foul. I am now trying him on CBD + 5mg THC in a gummy candy form. I've seen some positive calming effect for a couple of evenings now. I will hold off declaring it a winning hand until I can see that the effect is repeatable for at least a week. Fingers crossed. What behaviors are the most troublesome with your LO? Maybe one of the others on this forum will have some suggestions for you.

M1

LeBret we had absolutely no luck with any of the meds for Alzheimer's itself--way too many side effects (this in the face of needing lots of other meds for other medical conditions).  My partner did tolerate low doses of Seroquel (quetiapine) for sleep and delusions--started at 12.5 mg, now up to 50 mg.  And she is tolerating Zoloft (sertraline) for anxiety.  It is in fact a crap shoot.  

Regarding the Alzheimer's drugs, the figures I quote are that one in twelve will be helped, one in twelve will have intolerable side effects, and for the other ten it will make no difference one way or the other.  Sad figures.

Quilting brings calm

My mom was on a genetic Exelon patch for the dementia itself.  Discontinued because insurance quit paying.   I don’t think it really helped. It’s really hard to tell since this disease is progressive regardless of what you do.  The only change I’ve noticed in 3-4 months of not being on it is an uptick in anxiety. 

There is no way of knowing if that uptick is related  because she also is being treated for  anxiety and depression.  Medications seem to help for a while, during peaceful periods.  However the minute something stressful happens, then her anxiety and depression is back front and center.  Her current combination- generic Xanax and generic Remeron( that replaced Trazadone).  Does it make her slightly less alert?  Maybe, but if it reduces her anxiety and depression, it’s worth it to me.  The side effects of those two illnesses are stressful too and not just to her.  

We’ve only dealt with the Serequel and depakote for a few day period back when she had an undiagnosed UTI and was paranoid and delusional.  

I haven’t noticed any side affects from what she is on. 

You will have people  tell you that ‘that medication isn’t good for people with dementia’, black box warnings etc.  That’s all true, but I think their unmedicated suffering is too hard for them and their family members to endure. Keep trying.  

harshedbuzz

LeBret-

Managing psychoactive medications for a person with a diseased brain is something of a dark-art. It's best left to a geriatric psychiatrist who is the specialist in this kind of medicine. If your DW isn't seeing a geripsych, it would be worth a consult if you can get one. 

Dad never took any of the medications indicated for Alzheimer's. He was already on Prozac at the time he was diagnosed; his geripsych increased that a bit and added a low dose of Seroquel at dinnertime to treat aggression, disordered sleep and hallucinations initially. Over time, he added Wellbutrin to "activate" him a bit. It didn't work for that but it did lessen his craving for alcohol which was helpful for all of us. Dad was an alcoholic with mixed dementia (ALZ and an ARD called Wernicke- Korsakoff's). The geripsych eventually increased the Seroquel to 25 mg b.i.d. when the single dose wasn't enough to dial back the hallucinations, delusions and improve sleep. 

Three meds seems like a lot, but at low doses it gave symptom relief with minimal side effects. Sometimes a low-dose cocktail is a good option.

HB