medication recommendations

rachl999 · March 3

My dad recently was put on hospice to help with aggression we were hoping some medications would help., He is end stage but mobile with zero cognitive function. He recently became very violent and aggressive, redirecting is impossible. Hospice encouraged a geriatric psych facility. This was the last resort. He was admitted wed, they have only implemented Seroquel 12.5mg 1 tab 2 times daily. some relief. He is very week and i believe very end stage. We want to bring him home but for his comfort and family we want to make sure he doesn't go home too early and the aggression, hallucinations, get out of control and we have to start over. I feel he will be come home bed bound, might have aggression here and there in bed but not to the extent prior. What medications can a patient be prescribed for home and hallucination. I'm talking to the md and case worker tomorrow. im confused on why only Seroquel has been implemented. are there more we can implement. with hospice they had Haldol ordered but we cant figure out if it was making things worse. I know injectables or iv cant be given at home. what other antipsychotic, anti hallucination medications are the go to. This is just a quick over view, I apologize if its not a clear question. I would never stop typing about the situation over the past week.

DCCEPEK · March 4

MIL is on respidol, haldon and mirtazapine. Keeps her from being violent but she's end stage as well. Very withdrawn. There's days she will walk around circles and days she doesn't move. Doesn't eat or drink much. At 65 myself and give out.

rachl999 · March 4

Thank you. does or did she have hallucinations? if so did the meds help at all?

DCCEPEK · March 4

It was very bad hallucinating that would turn to delirium and last for days. Hospice has been with us for awhile adjusting meds as needed. I wish people understood how much help they can be. MIL isn't able to take trips to multiple dr for meds.

Hospice has been great

M1 · March 4

Seroquel will probably work just fine as a single drug, but they may have to titrate the dose upwards until the aggression is controlled. Hope it works out for all of you.

rachl999 · March 4

https://alzconnected.org/discussion/comment/200695#Comment_200695

we had hospice at first to try and help with the hallucinations and aggression. unfortunately t got so bad they said they cant offer anymore assistance no alternative meds can be offered etc. its so sad. and just devastating.

rachl999 · March 4

https://alzconnected.org/discussion/comment/200697#Comment_200697

thank you

towhee · March 4

They are probably trying only one drug at the time so if there are side effects they will know which drug they are coming from, and starting with a low dosage is normal, they might wait 5-7 days before increasing the dosage, it takes time, so long as they can handle him they probably will not throw multiple drugs at him. You can say you will not take him back until he is stable, so don't worry. The med might help the hallucinations, but the goal is that he is calm and not aggressive. I think seroquel is available in a liquid form, might be easier for you to administer.

rachl999 · March 4

Thank you. that makes sense. the projected stay was 5-7 days its a geriatric psychiatric facility. I don't quite understand their protocols and how they operate i guess. this a new area. Thank you for your help

ICalE · March 5

We tried Seroquel but it did not really help enough. So far all that has worked is Risperidone at 0.5mg either once or twice a day. We can get away with once a day along with 50mg of Zoloft for now. It wasn't physical aggression, just verbal, but I would bet it works for the physical too as it affects mobility at higher doses.

jfkoc · March 5

My husband was taking a much higher dose. If you go to asite like drugs.com you will find a lot of info.

AZGuy · March 5

https://alzconnected.org/discussion/68397/medication-recommendations

Hi rach1999,

I've seen a few medications mentioned for hallucinations and aggression. Some meds could be another name for something else. My DW's neurologist has mentioned Rexulti for hallucinations, restlessness and/or agitation. Some of my DW's agitation was TV programs we were watching. Backing off some of those seemed to help.

If Rexulti hasn't been mentioned or tried, you might ask your LO's MD about it and see what they think. There's always those darn side effects. But, all meds have them.

Best wishes. I hope something works for you.

M1 · March 6

Just one more comment: Rexulti is in the same family of drugs as the older medications quetiapine (Seroquel) and risperidone ((Risperdal). The company got it FDA approved for Alzheimer's by bothering to do placebo controlled studies, which I support, but it is vastly more expensive than the older drugs and not proven to be any better (i.e. there hasn't been a head to head comparative study). I doubt that it warrants the extra expense. The ads on TV don't tell you that.

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