Medications stop working - help

Drapper

My DH has dementia with behaviors (likely Alz) and has been on various medications for the past 9 months to control aggression and high anxiety.

Most recently seroquel, which I thought was working, but seems to not be doing the trick anymore. He is up to 50 mg am, 50 mg mid day and 25 evening. Also 50 mg Zoloft at night.

Recently he is getting difficult , anxious and stressed again. Also more obsessive over things like rocks and napkins than before. Dr has suggested I raise seroquel am dose to 75. (Which isn’t helping, but has only been a week. ) also has me experimenting with small dosages of Ativan. Both increased seroquel, and Ativan when I give it , seems to make him manic. (Only Benz thst ever worked was Klonopin)

I wanted to ask if others have had similar experiences with these drugs. And whether anyone may have any recommendations We have follow-up neurologist appt Friday

He does not get tired from them. He is 76, in good condition , does 100 pushups a day.

if he doesn’t get what he wants the second he needs it, he has a tantrum. Is also crazy hungry with hamburger cravings. Not gaining weight.

SusanB-dil

If you could get a video of the tantrum, it might help the doctor see what you are seeing. Please don't push for the tantrum, by any means, of course, but if you see a tantrum coming on, maybe be ready to video.

We have had to increase dosages at times, specifically memantine and donepezil, and within the past couple of weeks, we think the memantine has reached it's lifespan.

Best bet is just to ask the neurologist, though.

jfkoc

Ativan has a reverse effect for many...My husband was one.

M1

You've got lots of room to move still on the seroquel, i would put all doses at 75 mg until you can be seen on Friday

Drapper

Thank you for your comments. Always helpful.

I think that’s a good idea to get video of tantrum. Thank G-d not everyday. dr seems to push Ativan, but I think I’m done with it . We stopped Aricept with the seroquel but still on menantine

dr told me to only raise the am dose to 75, until I see her. He is best late afternoon and evenings. Sleeps well

I was wondering if anyone has experience with the other anti psychotics out there. Or other antidepressants Lexapro did not work .

His obsessions lead to anxiety And anxiety to obsessions It’s big bad loop.

tigersmom

Drapper, I have no experience with antipsychotics, but my DH has been on citalopram, an antidepressant which is generic Celexa, since March. It has helped, especially with his separation anxiety from me at daycare. Was it a cure-all? No, and we've gone up twice on the dose and i'm still not sure it's high enough. I will add that the one thing that jumped out at me in your DH's profile was the memantine. It made my husband exactly like yours sounds -- angry, impatient, aggressive speech, and this was 2.5 years ago in stage 4. It was like a preview of what was to come later. With his doctor's approval, I took my husband off it once he was titrated up to full dose -- 10 mg morning and night, and his old self came back pretty quickly. Of course, his old self is no longer with us anymore. You still might want to ask your DH's doctor if you can try weaning him off it. It does need to be titrated down, not stopped cold turkey. If your DH isn't really benefitting from it and it may be causing some of this agitation, it may be worth a try. My DH's doctor is a dementia specialist at a major medical center, and he said his threshold for stopping that drug was pretty low. Just a thought.

Drapper

Tigersmom, That’s an interesting thought about the Memantine. He has been on it for years, also at 10 mg am and pm. I will look to discuss that with neurologist. Maybe its usefulness is over. When he started it, 5 years ago , I noticed no impact from it

my husband has big separation anxiety issues, too. Many of his outburst come during time he is with a companion (2x a week , only 4 hours ). Zoloft isn’t helping. Neither did others in that class. I’ll ask about celexa. He will be fine, then mood switches suddenly.

such is life …..

jfkoc

While husband had a reverse reaction to Ativan I had one to Lexapro.

Drapper

Dr switched him to Paxil today. She was going to try Celexa, but said there can be a reaction with seroquel regarding heart arythmia issue, albeit rare.

my husband also had bad reaction to lexapro. Sorry to hear you did too.

I’ve been so against meds my entire life. But they do have their place, but there are no magic pills….

she doesn’t want to change more than one thing at this point. So keep Memantine for now.