Effects of Zyprexa and Seroquel

Daisie

My mom has been in the hospital since Tuesday because she seemed to rapidly decline. In the meantime, I've FINALLY gotten her Medicaid approved and found an MCF.

While in the hospital, my mom has become completely 100% delusional and has hallucinations. Apparently, she was trying to leave at night to look for me (which makes me want to cry, it saddens me so). I guess she got combative with one of the staff, so they've put her on Zyprexa and are starting her on Seroquel.

I'm wondering how quickly these work, if I can expect any improvement at SOME level in her cognition, and if they help stop the delusions and hallucinations. The MCF wants her regulated before they take her and then will take it from there. I was hoping I'd get time with her just as her daughter and not her caregiver, but now I'm saddened thinking that I won't.

M1

Daisie, is there a reason why they are trying to do this on a medical and not a psychiatric ward? On a psych ward she would be able to be up and around a little bit and not confined to a room and a bed. I would push for transfer if you can.

Anonymousjpl123

@Daisie First, I’ve followed your other posts and I think you are doing an absolutely amazing job caring for your mom under incredibly difficult circumstances - so please know that! She is VERY lucky to have you.

Second, i think her trying to leave the hospital is pretty common. My mom did that when she was hospitalized for delusions and paranoia last year. I dont know about zyprexa, but they gave my mom haldol, which i now believe is not recommended for dementia. It was just one dose so fortunately i dont think there were long term consequences.

That said, while nothing has brought back my moms cognition, seroquel has worked wonders on her mood and anxiety.

You absolutely WILL get time with her as her daughter. It just may be in a different state. She may be less of who you remember her as, but more comfortable. That is what has happened for my mom and i thank the god/goddess every day for it. Ideally she would be in geri-psych, but if thats not possible have they had a geriatric psychiatrist see her?

As you get ready to move her to her new place, knowing shes stable on the right meds will help a lot.

I remember being where you are last year and this truly is the worst it gets (or it was for me). Ask about the psychiatrist. And be sure to get some rest for yourself.

Daisie

https://alzconnected.org/discussion/comment/218731#Comment_218731

Thank you so much for your kind words! I literally woke up sick to my stomach with all this on my mind. I'm not expecting cognition to return, just some semblance of peace. I just absolutely hate watching this unfold. I'll ask about having a geri-psych see her if it's possible. I do think you're right about this being the worse that it gets. I think, in a way, it was a blessing to have happened this way because it would have actually been more difficult (and probably disastrous) to get her into MC straight from being at home.

I'm going to try to muster the strength and go back and visit her today. I'm absolutely exhausted!

Anonymousjpl123

Absolutely right about the transition. My mom, too, went from the hospital to MC and that made everything so much easier.

Please do find some time for yourself. This leg of the caregiving journey is particularly stressful, and it is a marathon not a sprint. Keep us posted.

M1

not to add to your burdens, but one reason I think she might be better off on a Geri psych ward is the fact that they have started two extremely potent drugs, Seroquel and Zyprexa,, within hours of each other. That’s going to make it virtually impossible to assess the effectiveness of each drug and will complicate things if she runs into side effects. I’d talk to the attending physician and push hard for transfer. Use this argument to bolster your case.

​fesk

Yes. I was just about to comment what M1 has posted. I was surprised to see Seroquel and Zyprexa being started at the same time. Please check into this and see if a geriatric psychiatrist can handle.

psg712

When my mom was in hospital for covid last year, not surprisingly she became very disoriented. Unbeknownst to me, she was medicated with a couple of different antipsychotics on different nights to keep her calm and stop her from trying to get out of bed. I found out the next day when she was hallucinating and had a terrible headache on one drug, and was totally unarousable on the other. Obtunded patients are easier to manage than agitated ones are.

All this to say that the additional meds your mom has been given may be with the short term goal of settling her down in the hospital rather than establishing an ongoing treatment plan. For what it's worth, the Zyprexa caused hallucinations and constant disjointed chatter for my mom. I hope you can find what works best for your mom!

Kat12345

I'm so sorry this is happening — I hate this disease! I did not take my Mom to the ER & so my situation was different. I am not surprised that things have spiraled in hospital. This is very stressful & serious; while you may find support & encouragment here please, please, please (also) find a competant person (s) to advise you & help you advocate for your Mom. Social Worker & psychiatrist with understanding of geriatrics. If you are not finding this at the hospital then please get in touch with your local Alz. Assoc., Family Caregiver Alliance are two I received help from. I was lucky that a social worker & psychiatrist walked through this with us (daily!), so to keep Mom out of ER; I knew from others I had met that (even if I had wanted) to place her somewhere that she probably wouldn't last there (because if behavior), & I'd have to find something else or (I feared) she'd end up a bedridden "zombie" from all the drugs & then all the crappy things that can happen if you stay in bed all if the time). It ALL broke my heart and I have not found any paths that are anywhere/thing easy, painless, etc., Your Mom is SO lucky to have you & you CAN get through this! So… only advise is to get help from professionals. I might get slammed here by some people who are so forthright with their opinions & (seemingly casual) advise; or maybe by the one ones who advise how to "dump" this on "someone" else (ie, I read someone - apparently - abandoned their parent at the hospital & advised to just say/do whatever necessary to leave her there & for "them" hospital staff, etc.) Every person with brain disease is not the same & situations also differ. I guess f or the person who dumped their parent at the hospital this was best I think that is heartless* & maybe a hospital is better in that case.

Ps) I'm not saying that you are this * — I can see that you care.

psg712

Kat, it is great that you have been able to access resources and support to keep your mom at home. Many are not able to do this. And I can see from your posts that it hasn't been an easy road for you.

But - No one on this forum is heartless. Each of us is struggling to do our best to care for a LO with dementia, to learn from others' experiences and to offer what we can to one another. If we didn't care, or if we simply wanted to "dump" the person we love, we wouldn't bother to read or post here. It is a heart-rending decision to take your loved one to a hospital or facility.

I want to see you supported here, just as I want to see others supported who have their LOs in a facility. It's kind of like the homeschooling/public school/private school debate among parents. Each of those parents want the best for their children but may make different decisions based on resources and personal circumstances. We can still support one another through the ups and downs of raising kids or caregiving for a PWD.

kblau

okay I read thru these comments and now I’m feeling anxious about my mom. She’s been in AL for 3 months. Needs constant redirection. Started to get agitated and aggressive. AL suggested MC. In the meantime she was seen briefly by geriatric psych who started her on low dose Xanax 3X/day. It’s been 1 week and I really don’t like how much she’s declined on it. Her move to MC will be at the end of the month to a new facility closer to me. I’m nervous. Social worker called me today bc last night she was wandering the halls and didn’t sleep AT ALL. I’m waiting on the psych to call me. BUT after reading everything here I’m wondering if taking her to a psych ward BEFORE she moves to MC is better. They need to find a course of treatment right Or else they’ll just call me and want her subdued?

Daisie

https://alzconnected.org/discussion/comment/218781#Comment_218781

No one here "dumps" their LO into an ER or hospital. Some of us aren't fortunate enough to have the resources to do anything else but take them to the hospital, where they can be cared for while other arrangements are made, often in haste because of a lack of availability, financial resources, etc. Unfortunately, this is the result of our inadequate and expensive healthcare system, complex social programs like Medicaid, the stigma of mental illness or cognitive decline, and a lack of empathy and understanding for caregivers like us who are family and not equipped to cope with the progressive and complex nature of cognitive decline. Family dynamic also plays a huge role, and I truly believe the dynamic between mother and daughter is one of the most difficult to navigate, especially in the face of adversity. Throw dementia in the mix, and it's almost a lose-lose situation.

M1

Well said Daisie! That's exactly right. It's a terrible dilemma. I wish there were a publicly supported way to buy in to long-term care insurance. Wouldn't solve everything but might help some? I would like to know more about how other countries handle this. Japan for instance ( oldest population in the world)....

Kat12345

https://alzconnected.org/discussion/comment/218816#Comment_218816

Very well said — thank you! 100%

I know it is hard to believe but I did read a post about the dumping. Sad.

Daisie

https://alzconnected.org/discussion/comment/218713#Comment_218713

@M1 not sure why in a medical and not a psych ward. I asked the doctor in charge of my mom about seeing a geri psych, and she said that my mom's condition didn't warrant that. She seems to feel she can get the meds right to stabilize her. She seemed fine last night and this morning, but by about 4, she sundowned and was bad again. It seems like my only other option at this point would be to get my mom out of the hospital and into adult foster care until the MCF is ready to take her, but I really don't want to put her through that extra move and confusion. But the MCF doesn't want her until she's stabilized on her meds, and their NP can take over and titrate her down once she adjusts. Right now, the future seems bleak. I can't see any of this happening and feel like I've made the whole situation worse. Forgive me. I'm not having a good day. I would rather not have my mom recognize me than be calm than recognize me and be so agitated and confused. I'd trade it for her in a heartbeat.

M1

I don't get the "doesn't warrant" bit. You have NOT made things worse. As you've said, they would not have taken her without stabilization. You did the right thing, hard as it is.

housefinch

@Daisie I am a pediatrician, so take @M1 ’s recommendations as your first guidance. However, I agree totally with everyone who has been puzzled by the team starting 2 antipsychotic medications at the same time. I also think she warrants transfer to geriatric psychiatry (inpatient ward) in an ideal situation. I completely understand having to work within the crummy system we have. I am so sorry you are walking this road. Please know that you are doing a wonderful job and that, although your mom doesn’t understand what is happening, she is getting the benefit of your love and advocacy. Keep on swimming and doing the best you can in the moment.