Heavily shaking and drugs

livlea

Mother is now in a semi autonomous home, she is adapting well but now realizes that something is wrong with her .. she does not understand Alzheimer but is terrified at her brain not functioning properly , she will say ; if only I could make my brain stay where it is supposed to be , I would have no problem..

She is extremely anxious and agitated , goes into extreme tremors/shaking episodes and cries, very painful to watch .

We are waiting to see a geriatric doctor, might take a while …

Meanwhile my question is :

Could it be side effects of medication, she is on low dose of Risperidone 0.5mg and Citalopram (for anxiety) 10 mg per day

Should the dosages be increased or reduced?

Is it better to « drug them » or watch them be terrified all the time ..

M1

All of the atypical antipsychotics can cause motor side effects, but I wouldn't expect it with such a tiny dose of risperidone. Tough call. You could try a cautious increase as long as you are watching carefully. Doubt that the Celexa has anything to do with it. Keep us posted...hope you can get her seen sooner rather than later. Is a hospice evaluation indicated, or is it too soon?

harshedbuzz

As M1 mentioned, the atypical antipsychotics do have motor side effects, but 0.5mg is a very low dose of Risperdal so that risk is small.

The crying could be that she needs a higher dose or a longer trial if it's been less than 6 weeks. Pseudobulbar Affect is another neurological condition that can appear with dementia that can present with crying.

HB

​fesk

Hi livelia,

Sorry to hear your mom is going through this. Your post said: "She is extremely anxious and agitated , goes into extreme tremors/shaking episodes and cries, very painful to watch ."

Was this happening prior to starting those medications? Any medication can cause an issue for someone. Everyone reacts differently. How long has she been on each medication and when did the issues start?

clarinetist

livea, my husband begged me to get him drugs to help with his anxiety, so I am on team drug rather than team terrified.

livlea

https://alzconnected.org/discussion/comment/225060#Comment_225060

Risperidone 0.25 mg was prescribed early 2023 for paranoia and delusions, very low dose ,it worked very well , it was then increased to 0.5 mg in dec 2023 (feb) still worked very well

The morning « sundowning » started in may/june 2024 , every morning : confusion ,pacing, agitation, crying ,she starts calling one of us @ 6 am , the staff is not available till 7 am , she needs help to know what to do, when to go down to the dining room etc.

By afternoon she is totally normal .

Citalopram was increased to 10 mg , no change , morning are getting worst .

It is all very weird

NizhoniGrrl

It sounds like she needs to be somewhere with 24/7 care. She shouldn't have to wait until 7am if she needs help. I'm so sorry!

​fesk

Please have any medical issues ruled out. Not sure when the Citalopram was started but maybe it doesn't agree with the Risperdal for your mother? No other change preceded the sundowning?

If you cannot see a direct cause for the behavioral change, it does seem as if her medications need adjustment.

It does also sound as if she may need more support.

livlea

https://alzconnected.org/discussion/comment/225098#Comment_225098

what where the drugs ?

livlea

Geriatric Dr. prescribed 35mg Zoloft increasing to 75mg after a month.

Anybody has Zoloft work for their person with anxiety ?

Dr . Also said to soon for 24/7 care, she is still walking around , has her « panic attacks in the morning » and then by afternoon is functional again..

She just cannot accept was is happening in her brain :(