Abilify

kasharb

Hello Everyone,

I do not post much BUT I depend on this forum as my support. My husband approaching the severe stage is really struggling right now with delusions and hallucinations. This has been going on quite a while but is happening everyday now and sometimes all day long. Our neurologist told us in April after putting him on max dosages of Aricept and namenda over the last 3 years that he had really done all he could for us but come back in a year and visit with our PCP when needed. We are close to our PCP so that is not a problem at all but this week he put him on Abilify daily and Flomax to help him sleep and not be disturbed with the urge to use the bathroom - he also gave him Xanax for anxiety when needed.

It is very scary to read about the side effects of Abilify so I am just wondering if anyone else has had experience with it for Dementia. And it concerns me based on my research to combine Abilify and Xanax. I can tell it is taking a toll as his eyes have no spark at all lately (I actually noticed this BEFORE we started these meds).

My husband has confirmed brain atrophy (ALZ diagnosis) as well as an artery in his middle cerebrum 50% clogged so he has been identified to have Mixed Dementia. I worry about the Stroke risk of Abilify per the side effects and the fact that he has a main artery clogged 50% which is also a stroke risk. He was diagnosed officially in 2021 but of course as you all know they will take their time ruling out to get the diagnosis which actually started in 2020 when we found the clogged artery. As I think back now our PCP has on record that I told him in 2013 that this was not the man I married - so I now know these were the beginning signs since probably 2012. He had colon cancer in 2008 which entailed chemo through 2009 and I believe and the neuropsychologist also noted in his report it COULD very well be part of the cause - I don’t blame it all on that because my husband worked shift work for 40 years so he did not have regular sleep patterns which led to central sleep apnea and when you factor in the clogged artery in his cerebrum I think it made for a perfect storm for Dementia. I just wish I had been informed earlier in this journey. He is 67 now diagnosed officially at 64.

Again just to thank you to each of you warriors who are struggling through this horrible journey with me. I gain much insight into my actions from your words.

gampiano

Kasharb,

When my husband lost the spark in his eyes , that was the beginning of his final stage of ALZ. Yes, he was on heavy meds, but the sparkle was fading before the meds kicked in. H e was also having delirium and hallucinations.

I contacted my local hospice and they came to the house and did an evaluation, after which he was accepted as a patient. I highly recommend doing this. They will make many resources available to both of you, and also provide respite if you need it.

Sending strength ,

Maureen

M1

All of the atypical antipsychotics like Abilify/apripiprazole carry that same "black box" warning about stroke risk, but they are the most effective class of drug for dealing with the delusions, hallucinations, and sometimes aggressive behaviors in late dementia. A 50% blockage in a cerebral artery is not critical, even though it sounds that way to most people.

Geriatric psychiatrists are the specialists who may be the most help in this setting, you can ask for a referral though there may be a lonewait. seroquel and Risperdal are more commonly prescribed than Abilify, which carries a higher risk for weight gain and high blood sugar.

Denise1847

I know nothing about the meds but my thoughts are that your DH's peace, as well as yours, are the priority. Longevity is not the goal. I always think how I would want my last days to be.

harshedbuzz

I second the suggestion to get your DH to a geriatric psychiatrist. IMO, the benefit of relieving upsetting delusions and hallucinations outweighs the risk outlined in the Black Box warning. YMMV. Dad did very well on Seroquel and it enabled mom to safely keep him home with her until about 2 months before he died. FWIW, dad's delusions drove anxiety, agitation and aggression that were terribly upsetting. His hallucinations resulted in minor annoyance (kids playing upstairs past bedtime was the most common) that could be easily re-directed. Some were even enjoyable such as when his golf buddies would "visit".

There is some data that suggests a relationship between the use of Flomax and dementia. I would ask the doctor if this is something that should be avoided at this stage of his disease. Some caregivers here have taken their LOs off this medication, but your situation might be different.

HB

kasharb

Great thoughts everyone! Thank you so much for the advice. This forum is a lifesaver for me.

CStrope

I have been giving DH Risperidone to help with his hallucinations, and it seems to help. I only give it to him during the afternoon though because when I gave it to him at night it made him so loopy that he was urinating all over the house. He still manages to get up and take himself to the bathroom at night, so I decided to forego the evening dose. He seems to enjoy talking to all of his imaginary friends, so I'm not really concerned at this point about stopping it. As long as it keeps him happy and occupied he can go on talking to the dog, the pillows, and himself in the mirror as much as he wants. I realized it is definitely more upsetting to me than it is to him.

jfkoc

Abilify is not approved for use in older adults with dementia-related psychosis....Drugs.com.

Unless the delusions and hallucinations are distressing I would not worry about them.

A geriatric psychiatrist is the correct Dr to be caring for your husband now.

I applaud your attention to the drugs your husband takes. Drugs.com is a good site for checking interactions.

easy23

Rexulti is a FDA approved antipsychotic for Alzheimer's patients.