Anxiety and Depression
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Please share medications that have worked for anxiety and depression for dementia parents.
My sweet mother is in late stages of dementia and cries at the drop of a hat and we have no idea why and she can’t tell us.
I’ve read about different options but many meds state they’re not good for those with dementia and can cause more forgetfulness and confusion.
I’m working with her general practice doc and neurologist but would like to hear what has been successful for you.
Comments
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Lexapro.
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Hi BillyB - your mom could have pseudobulbar affect syndrome. This syndrome is uncontrolled laughter or crying for really no reason. MIL's doc wanted to try Neudexta, but first, it wasn't a covered prescription, and also, we weren't so sure we were willing to deal with side-effects. A low-ish dose of Seroquel has worked, and has also helped her depression.
MIL was dealing with depression, but then would also giggle or laugh verrrry inappropriately at things, or at a bad time, such as a funeral. The Seroquel also dialed back a bit of the anger towards me. She is on a cocktail of a few meds, but the seroquel really helps for the depression and the crying/laughing jags.
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I’m not a doctor, but I think many medications are not recommended for people with dementia. Some of these warnings may be for long term use (if she is in late sate, will she really be taking it for years? I know this sounds harsh, but If she is bed ridden how much does it matter if the medication makes her dizzy? Does it really matter if she is more forgetful. I think you have to weight the side effects with the benefits. I had a really hard time when mom moved to AL and she received a dessert with lunch and dinner (she is diabetic). It took me a while to accept that dessert makes her happy and it wasn’t really going to make that big of a difference. I want to warn you that medicine can take a while to work and they usually start with a low dose and only after several weeks will they increase the dose. If it doesn’t work she will probably need to be weaned off and the whole process starts with a different medication. I hope doctors can find something that work for her anxiety and depression along with the dementia is miserable.
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The crying in and of itself does not necessarily mean she is depressed. Laughing or crying inappropriately in a syndrome that can be treated with a particular drug(the name escapes me) if that is actually the affliction.
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What was successful for us, was adding a geriatric psychiatrist to dad's team.
IME, the PCP was great for medical issues and the neurologist was great for doing a comprehensive evaluation, but for both aggressive treatment of mood/behavior was outside their wheelhouses.
Because dad was paranoid, delusional and agitated, he did well on a very low dose of an atypical antipsychotic (Seroquel 25mg b.i.d.), an NDRI (Wellbutrin) while continuing with his SSRI (Prozac). This cocktail allowed him to take lower doses and avoid side effects from higher doses and combined they really dialed back his upset.
Seroquel is one of the meds often listed as contraindicated in the elderly and PWD. It can be associated with fatigue, increased fall risk and even sudden death but that is less common in the low doses used in dementia. We weighed the risks of him being placed earlier because it was not safe to continue at home in his current state vs the improved quality of life and remaining in his own home until weeks before he died.
HB0
Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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