Medications(2)

Nancy Anne

My DH is in early stages of dementia and has terrible anxieties and depression. His  Neurologist has him on two medications for this. They are helping a little.  Now he wants to add Namenda to help with his memory.  Has anyone had experience with this drug?  He was on Aricept when first diagnosed but could not tolerate it.  

Ed1937

Here's a fairly long thread on meds. https://www.alzconnected.org/discussion.aspx?g=posts&t=2147543106  

Stuck in the middle

DW has taken Namenda since 2017.  We see no side effects, and her symptoms are progressing slowly.

Ernie123

Hi Nancy Anne: I will share my DW’s experience with medications in the hope it may help you. My DW was diagnosed in 2012 with Alzheimer’s. She is now in late Stage 6 living in MC for the past two years. Early on she was prescribed Aricept but like your husband could not tolerate it due to nausea. Her doctor switched her to a 24 hour slow release patch, Rivastigmine, which was tolerated much better. However, any benefit from any of the memory meds is hard to determine as one would have to know if progression would have been faster without them. Don’t expect much, memory loss will continue.

As well like your DH my DW had severe anxiety in her second and third year which was totally out of character for her. Her family doctor prescribed Escitalopram which helped ease her mind. Which particular medications may work and at what dosage requires a bit of experimentation. We tried a couple of different “prams” and dosages before things settled out. You need patience and persistence.

A couple of years later when my DW was starting to become delusional and paranoid, family doctor referred her to a geriatric psychiatrist. Very important move. Once again a bit of trial and error before a medication and dosage level was found that gave her some calm and a less agitated state of mind. A geriatrician or geriatric psychiatrist with experience who can follow your DH is very important in my opinion. As my DW’s disease progressed, a reassessment of meds was needed every six months or year or so. Having the same specialist who has had her as a patient for many years has been important to help keep her as comfortable as she can be. She has had several occasions of upset that required switching meds, changing dosage levels. Every patient is different and as the disease progresses this constant monitoring and fine tuning is important. I have seen unbelievable improvements in just a few days from a medication adjustment. For example, going from extreme agitation hiding in her closet because people were coming to get her to relaxed and smiling in the common room two days later because of a switch to a different antipsychotic medication. 

In my experience medications cannot stop the relentless progression of Alzheimer’s. But they can make the journey much more tolerable for you both by relieving some of the more difficult emotional symptoms.

Bob C

My wife Sue--67 y.o, diagnosed 7 years ago--s experiencing behavioral issues (agitation, early morning bouts of combativeness with memory care aides) and is now in a geriatric psych unit after a fall where they are adjusting her meds to find the right mix for that behavior. Abilify was not effective. May I ask what was prescribed in your case, everyone is different but curious to see if it matches up with what they are trying with Sue. 

Thanks

Nancy Anne

Thank you, Ed,  I appreciate you sending the link to all the threads on medications.  It seems to be mostly trial and error.

Nancy Anne

Thank you, Ernie, for taking the time to send your experiences with medications.

Unfortunately, I am learning that the medications work differently in most people.

I appreciate your input and wish you and your DW some peace on your journey.

Nancy Anne

My DH is currently taking 30mg mirtazapine (Remeron) daily to help him sleep and for depression and anxiety.  100m Sertraline (Zoloft) because he is still very anxious and depressed.  He will start on Memantine (Namenda) in a few weeks after he has been on the increased dose of Sertraline.  First started with 50mg and now increased to 100mg. of Sertraline.

Good luck with your DW medication adjustments.  It must be so exceedingly difficult to go through this experience at such an early age.

jfkoc

There  is a major interaction between the Zoloft and the Remeron you will want to read about.

https://www.drugs.com/

storycrafter

Like everyone says, each body is different. I'll just share...my husband's (FrontoTemporal Dementia) experience on Zoloft was not good. He became even more anxious, jittery, and agitated on it.  Seraquel was a life changer, though, and helped immensely once he aclimated to it. He also takes generic Wellbutrin and Propranolol. Good luck in your search. Hope you soon find what works better for him.

Smitty46

My DW has been taking Arecept and Namenda for three years.  I have observed a steady decline in memory, daily functioning, speech and communication.  For the last several months she does not want to take the pills.  I talked with the nurse practitioner at our Doctor's office.  She spoke with the Doctor who advises that discontinuing the medication may be best. 

I am torn between trying to do something to help her and at the same time, I realize that regardless of what is done, I am losing her.  According to the psychiatrist who evaluated her condition, he believes that she has been suffering from Alzheimer's for five years.  She is 75 years old.  

How do others handle the moral dilemma?  On one hand we want to help.  On the other we know that nothing we can do is going to bring back our loved one.  I would like to hear from others about how they deal with this.  I am the caregiver for my wife.  We have been married for 53 years.  I am in good health and am coping so far.

Nancy Anne

Smitty, it is a terrible thing to realize you are really losing your DW.  I dread the day that I will have to admit that.  Try to make the most of each day that is a good day. I am sure they are becoming fewer and far between.  I hope you are taking care of yourself and able to have some time away.  I plan to have in home care when the time comes when I can no longer do this alone.  I pray you will receive some help and guidance.  For what it is worth I started seeing a psychologist to help me deal with what is ahead.  Thankfully, she and I have really connected and after only two visits I feel like I have someone I can really talk to.  She is truly knowledgeable about the disease having gone through it with her own father.  I found her through the Alzheimer's website.  I am sorry I don't recall how I did it, but if you search for psychologists within the Alzheimer's website, it may lead you to someone in your area. 

Stay strong and know you are doing all you can for your DW.

Nancy Anne

Thank you for the link.  We know about the potential interactions and after talking to a pharmacist he was introduced to the sertraline very slowly and has tolerated the combination.

Always be sure to trust your pharmacist to give good advice.

Ernie123

Smutty: I shared some details of my DW’s experience with meds earlier in this thread. You and I have much in common except my wife in stage 6 is further along in progression and lives in MC. She is75 and we have been married 54 years. In answer to you question about how others cope, I can share what has helped me. I continue to learn as much as I can about the disease so when I witness my DW progressing I understand better what is happening. I have attended many workshops sponsored by the Alzheimer’s Society about the disease and it’s effects on caregivers. This helps put things in perspective, not just about my DW disease, but also the stress and grief we experience as caregivers. As you note, the helplessness of being a caregiver who cannot really effect any help is stressful. But that is the nature of the beast. We must witness the slow decline and somehow accept it. I also attend support group meetings once or twice a month. The experience of sharing my story over the last few years with others who are in the same situation, giving and receiving advice has been my main support psychologically. I don’t feel as alone in the world, I have built new friendships within the support groups who truly understand how I feel. You cannot deal with this on your own so reach out and take advantage of any support groups that may exist in your community. That is why this forum is so valuable. It gives members a chance to open up in a non judgmental setting and share their grief and challenges, their successes and perhaps help someone get through another day. Even though we have not met I believe I understand only too well what you are living through.

jfkoc

Nancy...I agree. It was our pharmacist who directed me to drugs,com when a drug was added instead of increasing the dose of the drug already being taken.

Pat6177

Smitty, I handle the moral dilemma by going along with my husband’s wishes, even though I don’t always agree with them. In the past year he has refused: getting his hearing tested, a CPAP machine, cataract surgery, a colonoscopy (he is having some off and on abdominal pain), PT for balance, annual follow up for lesions noted on lung scan. He’s made it clear that he doesn’t want to live a long time (he’s 78) and so doesn’t see the point in doing all these things. It is his life and his body and I try to allow him the dignity to make his own decisions. Yes, I try to reason with him but he’s adamant. He is on Aricept and Namenda and he grumbles about them, saying they aren’t helping. I fully expect one day he’ll tell me he doesn’t want to take them anymore. And I’ll go along with it. I didn’t come to this acceptance easily but it does feel right to let him choose. My DH is late Stage 4/early Stage 5. Now, after saying all that, 6 mos ago, I made him go to Urgent Care for an infection.

ImMaggieMae

Nancy, my DH has been taking Namenda (memantine, the generic version) for at least a year  and a half. He also takes Risperidone. His neurologist increased his dosage of memantine from 5mg twice a day to 10mg in the am and 5 mg in the pm. I could never tell in the past if the memantine was helping or not, it’s mainly supposed to slow progress. But after about a week on the increased dose I have seen several improvements. He is eating better, he’s smiling again, more talkative and his urinary incontinence is slowing way down. He wears Depends but uses uses the toilet pretty much all day, where before it was maybe a third of the time. After 8:00 in the evening when we’re watching movies and during the night I still have to change the Depends. But he is increasingly getting up to use the toilet in the early morning. No bowel accidents since the med change where he had the occasional accident before. 

He’s also able to dress himself now if I lay out his clothes. 

He is often expressing empathy again, something that had disappeared almost a year ago.

I know this is probably just a reprieve for the past 3 weeks of so, but it is a welcome one.

Nancy Anne

ImMaggieMae , Thank you for the feedback on Memantine (Namenda).  I am very hopeful for a good response to the medication even if only temporary.   He will not start it until Aug 1st since he is adjusting to an increased dose of Sertraline.  We can only pray that our LO will be happy again.  I try to have a positive attitude and will accept any improvement if only for a brief period.

ImMaggieMae

Nancy, in looking back at the calendar, it’s actually been more than 5 weeks that DH has been doing a lot better with the increased memantine. I hope this lasts a long time. I hope your DH has similar results.