Medication for angry outbursts

clndaniels

My DH withALZ has been pretty docile until about 1 month ago when he had some undiagnosed infection. Prednisone and Z-pac cured the infection but since then his mood has deteriorated. He has started being argumentative, cussing and refusing to cooperate with me or caregivers. His neurologist  has prescribed divalproex to help. Has anyone used this for these symptoms?

MaryG123

Is he off the prednisone now?  It can cause mood and behavior symptoms, but they should resolve when off the meds.

Ernie123

My DW has required antipsychotic meds for several years to help her with delusions, paranoia and agitation. Similar to your experience it started with angry outbursts but combined with delusional thoughts. She was first prescribed Escitalopram, for anxiety, and Risperidone for the emotional outbursts. As her condition progressed the Risperidone was replaced with Olanzapine, which was more effective for her. Both drugs were adjusted as needed over time. The geriatric psychiatrist said every patient is different and a trial period with adjustments is usually needed. In my experience you need to hang in there and be prepared to have the dosage adjusted or the prescription changed as time passes. I will say these meds have been a tremendous help for her relieving her of paranoia, delusions and fear and the emotional upsets that result. You are wise to have a neurologist helping you. These unsettling changes in personality cannot be effectively managed by a caregiver through words or distraction. If untreated these uncontrollable outbursts can quickly escalate to violence which you cannot risk.

It is a terrible disease and I wish you strength as you navigate care.

clndaniels

Yes, he is off the prednisone, but outbursts have progressively become worse since that time. Will advise if meds help.

clndaniels

DH has been on lexapro for many years. The neurologist added adivan for extreme agitation at night. Yesterday he added continued release divalproex . I see some improvement, but not back to previous behavior.

toolbeltexpert

My dw  takes Lexapro and olanzapine they have helped but they have their own side effects. Was the infection a uti? Sometimes they don't clear. Those behaviors are hard to deal with.

Hope you get some relief.

M1

cln, there are a lot of drugs that can be used/tried in these situations, and sometimes it's dealer's choice:  Depakote/valproic acid can be used for seizures, bipolar disorder, as well as for dementia behaviors.  Other choices would be quetiapine, risperdal, olanzapine (Zyprexa), Haldol in exreme cases, and the SSRI antidepressants (though they have less immediate effects on aggression, sometimes they will be used in combination with one of these other drugs).  With Depakote they may check drug levels and/or liver function tests, as these can be affected.  You could ask the neurologist if there was a reason for the choice and you may or may not get an answer.  But there should be an observable effect on behavior pretty quickly if it's going to be effective.

Hope it works off the bat, that would be nice...

clndaniels

Haven’t posted here in awhile. DHWD was place in a MCF in October. Some experience is good and some has been disappointing. As with many businesses these days, they can’t seem to find competent, willing, and caring help. The caregivers who are there for the long haul are wonderful, but they are overworked, and can suffer burnout, just as we do. As DH has declined, I have had to secure outside caregivers, at my expense, to cover their lack of service. Also, it has been suggested he needs SNF care . Finding availability scarce in our area, and we are in highly suburban area, has been a problem. Some SNF don’t accept MC patients, others have long wait lists. Very frustrating. 3 new MCF have been built recently, but no new SNFs.