Medication Thoughts: Quetiapine, Risperidone, Lorazapam, ABH Gel

shark_guy

My wife is in Stage 7 Alzheimers per the FAST Scale and has changed her behavior in the past weeks including being more Anxious, Confused and Combative. This week she had what I would describe as a hallucination episode and was very anxious, upset and uncontrollable for about 30 minutes. She has severely restricted her food and fluids intake and is losing weight, about a pound a week recently.

She has been prescribed the Queitiapine for Anger and Anxiety but we are not giving it to her yet and recently her Neurologist prescribed Risperidone as an alternative if she cannot swallow the first medication. We are concerned about the possible side-effects as they seem possibly severe and the Drugs.com site states that these medications are "not to be given to elderly patients with dementia"! A new caregiver also suggested Lorazepam and ABH Creams.

Any experience or knowledge about the use and effectiveness of these drugs or their risks or side-effects would be appreciated.

Quilting brings calm

She’s in stage 7 and is losing a pound a week. It doesn’t matter what the medication side effects or warnings are. She is at the end, at this point, whatever makes her comfortable is what’s important. She isn’t going to he on the medication that long. Even if the worst side affect happens, it’s not going to change the outcome.

Have you called in hospice yet? If not, you should.

SDianeL

my husband was on Risperidone and near the end they had to add Depakote due to his aggression. If your DW is losing weight and not swallowing I would call in Hospice. They are wonderful and will answer all your medication questions. As Quilting brings calm said no need to worry about medication side effects at this point, just keep her calm and comfortable. Once they start her on medication she may sleep most of the time. They need to start the medication asap because some take time to build up in her system. That’s where hospice can help. And once they put her on medication, keep talking to her as she may be able to hear you even if she can’t respond. 💜

harshedbuzz

@shark_guy

Weight loss to that degree is ominous and correlated with death expected within 6 months. If you've not engaged hospice, it's time to.

I would not hesitate to use one of the atypical antipsychotics in a PWD beyond the earliest stages despite the black box warning. We added Seroquel in stage 5 for dad and increased it to twice daily in stage 6 when his sleep pattern became disordered and was impacting mom's ability to keep him at home. The Seroquel dialed back his delusions, hallucinations and agitation which was a blessing for him as he didn't have the cognition to process them.

HB

shark_guy

Thanks to all who responded. Yes, it seems you were correct and I did engage Hospice and am so very glad we did. Her nurse predicted she has about 60 days left… Thanks again for all your caring words.

midge333

With declining oral intake and steady weight loss, your wife is nearing the end of her life. If you have not already done so, please ask for a hospice evaluation. Her comfort is paramount. Seroquel (quetiapine) and risperidone are widely prescribed for agitation/anxiety in elderly dementia patients. These medications are very effective. I am also be concerned that she may be in pain and could benefit from a hospice evaluation.

SDianeL

https://alzconnected.org/discussion/comment/240293#Comment_240293

so sorry. Keep talking to her. She can probably hear you even if they start morphine. Hugs. 💜

Scooterr

shark_guy, My DW is, or I should say was, in the same condition as your DW (stage7). weight lose, uncontrollable, hallucination. . The best thing I did was get hospice in. Once they were here the door opened up as far as medication. They asked me what I wanted, not our PC or neurologist telling us what we needed because they were worried about some addiction. At this point what the hell does it matter! We went for the risperidone, Lorazepam and clonazepam for sleep. Everything has calmed down and we're able to continue this nightmare with so peace. The only regret I have is not calling them sooner. Good luck.