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Agitation and anger and a couple of questions

Anna2022
Anna2022 Member Posts: 185
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My DH is starting to have angry outbursts when things don't go his way. It's intermittent but noticeable.

For example, he gets easily frustrated around tasks that used to be easy for him - the TV remote is the most recent source of frustration- he has replaced the batteries several times in the last few weeks, blaming faulty batteries rather than "operator error." If I offer to help, he gets angry at me and refuses any assistance (I have learned to wait until he asks for help, all the while keeping an eye out for escalation)…What can I do to help him manage his anxiety/agitation/frustration around this?

His agitation and anger is short-lived but lately getting more frequent and is produced by more and different events.

He usually has no insight into his issues but last night he had a moment of clarity and said, "I used to be on top of all things, now I can't even use the TV remote."

Is it time for medication help? He currently takes Sertraline but is there something to use as needed if the anger and agitation becomes even more pronounced and longer-lasting? Maybe ask to increase the SSRI dosage now? What meds are indicated for agitation and anxiety? I read here that Seroquel might be an option…Is it too early to have Seroquel at the ready? Is it available in liquid form that I can add to a glass of water? And can it be used intermittently or is it another daily med?

I will contact his doc on Monday but I thought I would ask here for input as well. I manage his medications but we still participate in the fiction that he is in charge … and I know he will resist at needing an additional medication or changing dosages but I'll cross that bridge when I come to it.

Comments

  • Jeanne C.
    Jeanne C. Member Posts: 841
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    Definitely discuss with his provider. Seroquel and Risperdal are both atypical antipsychotics. They help with aggression, agitation, obsession, delusions, and hallucinations. If appropriate, the doc should start him on a low dose and gradually increase as needed to be effective. I don't think either can be given as needed, because they need time to build up to efficacy and both require that the patient be weened off rather than suddenly stopping. I believe both come in liquid form.

    We've had some success with the combination of Lexapro and Risperdal for my husband with FTDbv. Dosage adjustments have been needed as he has progressed, but we're infinitely better off than before the meds.

    I'm hoping one of the medical professionals in the group will chime in.

  • M1
    M1 Member Posts: 6,788
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    definitely not too soon to try low dose Seroquel, it would probably help him sleep through the night too. It should be given daily though and not “as needed.”

  • tigersmom
    tigersmom Member Posts: 224
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    @Anna2022 , I would definitely ask his doc about the antipsychotics. We are in week 3 of low-dose seroquel, and while it doesn’t seem to be working wonders for DH’s cognition, it has helped with the angry outbursts. Starting dose was 25 mg twice a day, raised to 50 mg twice a day after 4 days. Most of the SSRIs have dosage limits in older people, and DH was already at the max (20 mg) for citalopram (generic Celexa). Many PCPs and neurologists do not want to prescribe the antipsychotics, including DH’s neurologist. I had to find a geriatric psychiatrist who would. So if you get pushback, do as @M1 advised me, and push right back. Good luck to you.

  • Anna2022
    Anna2022 Member Posts: 185
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    Thank you @Jeanne C. , @M1 and @tigersmom . Your help is invaluable!

  • Anna2022
    Anna2022 Member Posts: 185
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    @SDianeL So very sorry to hear about your DH issues with anger. I do hope the docs find the right dosage, he must be miserable. And you must be under a lot of stress! Thank you for sharing your insights!

  • ImMaggieMae
    ImMaggieMae Member Posts: 1,041
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    @Anna2022 I would definitely plush for Seroquel or Risperidone. My DH took very low dose Seroquel that was raised a couple times over a months time and didn’t help for extreme agitation. He was put on Risperidone, which is like a wonder drug for him. The one he takes is liquid, measured with a syringe and squirt in his mouth. You could probably mix it with pudding or something but it’s such a tiny amount that I wouldn’t add it to a glass of water. My DH has never resisted taking it. He knows it makes him feel calmer. It’s something that has to be taken daily, usually in two doses. It doesn’t generally make him drowsy.

  • Anna2022
    Anna2022 Member Posts: 185
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    @ImMaggieMae Thank you for the insight!

  • harshedbuzz
    harshedbuzz Member Posts: 4,584
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    Seroquel allowed mom to have dad home safely until about 7 weeks before he passed. His geripsych was the most valuable person on his team aside from mom.
    HB

  • H1235
    H1235 Member Posts: 630
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    I agree that medicine might be the best route. As far as the tv remote and other things that anger him, what if you found a way to do it for him and allow him to not feel like helpless. For example “Is the tv remote acting up again I had trouble with that the other day. I’m not sure if I can remember how I fixed it but maybe I can give it a try”. If he is struggling to cut up his chicken, cut up both yours and his and claim you’re trying a new recipe. I know it hard to come up with something creative like that at the moment. Easier said than done. Good luck.

  • Anna2022
    Anna2022 Member Posts: 185
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    @harshedbuzz Your input has been fantastic whenever I see your responses. Thank you so much for sharing your experience, strength and hope.

  • Anna2022
    Anna2022 Member Posts: 185
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    Good ideas! Thank you!

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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