Medications for irritability

Daraj

Hello. My mom has recently become on edge. She is battling bouts of severe depression and anxiety because she is losing her independence and ability to dress herself. Lexapro has now been prescribed to her but I would like to hear of our caregiver struggles with this topic.

Cosmic

I think some days the "on edge" situation will change. My limited experience is that the daily roller coaster has ups and downs. She may be irritable one day and quite calm the next. The depression is heartbreaking. My wife of almost 60 years is/was an accomplished professional oil paint artist with sales and awards. Her work hangs on our walls and she occasionally breaks down in tears because she knows she did the works of art and is no longer able to. She actually gets angry because she can no longer do other things. I try to change the subject but that doesn't always work so just journey through it the best you can until the move on to something else. 

Medications for depression and anxiety help somewhat but not always. It took weeks for me to find the exact time schedule when to administer them. Even then it's not a certain science and there will be days that nothing works. I find that distraction and changing subjects helps.

Dressing oneself can be made easier by setting clothes out in the morning or evening that they can easily put on. They can no longer decide what to wear so you have to make the decision yourself. Make sure there are clean undergarments daily. There are usually some favorite outfits or articles that she likes, put them out for her, she won't remember if she wore it yesterday or a few days ago. In the evening I will put out a pair of PJ's, lay them out on the bed and she will change by herself. I found that when I do laundry and fold clothes leave the fresh ones out for a while and she will eventually pick something she likes.

Not much advice here but it's what I do.

MN Chickadee

Do you have a sense of what stage your mother is in? For my situation, stage 5 was the hardest in so many ways. My mother had severe anxiety and depression as she lost skills and abilities and also lost respect when it comes down to it. The indignity of family members constantly stepping in to do something she used to do, having random members of the public treat her differently, her friends and social life started falling away.  I am sure it is incredibly scary and frustrating. We added a SSRI and it helped some. Also do as much reading about the disease and communication techniques as you can. Understanding the Dementia Experience is a good read, and any video or material you can find by Teepa Snow. For some, at certain stages, these approaches can help, sometimes not. Finding the right way to communicate, finding ways to engage them in every day life and let them be "useful," finding things to occupy their time that isn't repetitive ruminating or anxiety driven is a good start. We found adult daycare played a big role in mom's mental health. She spent the day doing activities with wonderful staff and peers who had dementia, she had exercise and music and pet therapy and all kinds of things. She came home tired and fulfilled and would watch TV for a bit after dinner and go to sleep. This routine worked well for quite a bit of late stage 5 and early 6. The hardest days were the weekend when she was out of this routine, that's when the anxiety and behaviors were challenging. Finding an outlet for them that is safe but also something they enjoy is really important. 

Sometimes caregivers have to amp up the pharmaceutical interventions to something more heavy duty if the anxiety gets out of hand. Sometimes the best we can do for our LO is safe and cared for, happiness can be very elusive with dementia. Fortunately my mother mellowed out in stage 6 once she was less aware of what was going on, and was very easy going and happy at least some of the time. The best advice I have is to find those moments of joy with her, no matter how brief or rare, and hold them to your heart closely. I hope you can find them. They will carry you through. 

CanyonGal

I agree with MN Chickadee, stage 5 is difficult. I think we are seeing some crossover to stage 6.

Mom is sometimes listed as having moderate dementia to severe dementia. It's like she is balancing between the two stages. 

When she was in rehab recovering from an operation, she started being treating for depression with mirtazapine (remeron).

Hospice added Lorazepam (Avitan) for anxiety, agitation. The agitation was at its high when she began sundowning.

It is heartbreaking to watch the mind slip away. I sometimes question if Aricept and Namenda are helping.

She taking so much medication. Today I looked each one up and wrote what they were for to see if any of them could be eliminated. The supplements perhaps: CQ 10, aspirin, probiotics, and multivitamins.

Her PCP and Hospice disagree on hyoscyamine - secretions. She was gagging on the amount of nasal discharge and that has helped.

ChHodge

Hello Daraj!
So sorry about your mom! My father used to take Lexapro from https://www.canadapharmacy.com/ . But I didn't like the effect of drowsiness it gave. My dad looked too tired and always wanted to sleep. So we asked the doc to change his medications.