Update

@White Crane , I am so sorry to hear how this is going for your DH. I found at the hospital I had to really sit on them about the drugs. There were some days my DH was so overmedicated he was practically catatonic. Since they were experimenting and that’s why he was there, I tried to be patient. But when I really needed to speak up — by the end they were giving him seroquel .25 mg at night to keep him asleep — and he was really out of it the next day, I got them to halve that dose to 12.5 mg and it worked just as well. Can you get the doctor’s phone number from the facility and call or text him/her? Where my DH is, everything seems to happen that way,even when I am in the building. The hospital released DH on NINE medications, four of which were over the counter meds. I have asked the facility to hold three of those until I can speak to the doctor tomorrow. Pushing drugs is what hospitals do, and in DH’s case, giving him too many seems to make him stop taking the ones he really needs.he was totally compliant at home, but he was only on three meds. Don’t give up. Please keep being the squeaky wheel, as @M1 would say. It is the only way to get things done in a healthcare setting. Hugs to you.

@White Crane

I am sorry this continues to be so frustrating and disappointing for you.

Two thoughts. Firstly, did the doctor change the Seroquel for Risperdal (generic risperidone)? They're very similar medications and would typically offer the same results in terms of agitation and sexual behaviors. Both medications have a reputation for sleepiness, so that could explain the doctor attempting to lower that dose and adding the Lexapro (an SSRI) that is generally thought of as a "safer" medication with a similar calming and sexual-urge dampening results. My dad was on a Seroquel/Prozac cocktail for similar behaviors; combining them meant he could take lower doses of each which helps keep dosage-related side effects to a minimum.

My second thought is the Lexapro. It's generally thought of as one of the better SSRIs in terms of efficacy vs side effects. I took it for a little over a year not long after it was first released primarily for a recurrence of PTSD and anxiety— MIL was dying, my home was destroyed in a flood, my DH was being bullied by a manager at work/traveling constantly and my son was struggling in school/being diagnosed with autism, ADHD, GAD and dyslexia. I was a hot mess, and it initially allowed me to be OK— I was able to function and power through all that I needed to do. About a year later when things settled down, I found that the Lexapro started to cause side effects— while tiredness is not uncommon with it, I found myself sleeping 10-12 hours at night and craving naps. More terrifying was that I had trouble remembering things which is why I weaned myself off of it. I'm told this degree of sleepiness and confusion is "very rare" (less than 1% of users report it) I would absolutely consider it for PTSD, but for my current situational anxiety my PCP and I opted to go with Wellbutrin.

HB

Brenda it is beyond frustrating that the doctor won't talk to you when you hold his medical power of attorney. You may want to mention that when you "squeak," as you should definitely do.

If he's not acting out, the risperidone is probably working. The question of whether it's too much is hard to answer—I do think in general it causes more somnolence than Seroquel. But a lot of folks sleep more with progression anyway. This is happening to my partner too, and things we used to do to stay occupied—art projects, puttering with plants—have gone completely by the by. We occasionally sit outside when weather allows, otherwise she's pretty much in bed.

I would find out when the doc or any associated nurse practitioner makes rounds and park yourself by the bedside, with communication with the director of nursing that you MUST speak with them.

I wouldn't worry so much about the aspirin at this point. Hard to give these things up though, I know.

I would be cautious about Wellbutrin. It can decrease appetite and can activating. It has a reputation for being the least likely medication of its kind to decrease sexual desire; specifically it can sexually activating. DS's psychiatrist (he specializes in high functioning ASD, ADHD and Bipolar) will not routinely prescribe it for male teens and young adults in his practice for that reason.

There are other SSRIs that could replace the Lexapro. You could also ask why he felt Risperdal is a better fit than Seroquel and whether the dosage is similar.

The way you are being treated, lack of communication and answers is infuriating. Forget squeaky wheel and opt for pain in the a#$! When my DH was in the hospital for agitation, I ran into the same thing. I phoned, emailed and asked questions on a patient portal when one was available, often several times per day. I had calls in for everyone who was connected with his case. I finally got answers after a few days and his meds were straightened out. The hospital psychiatrist spent about 45 minutes talking to me and explaining medications and how to administer them at home. I haven’t had problems with communications with any of his doctors since.

Brenda the things I would question: why give risperidone in the morning and not at night? Why dose trazodone three times a day ( typically dosed only one a day and also at night)?

I ran these through Drugs.com and found two major interactions and the rest had moderate drug interactions. I would go there and print out the information. I would copy and send to the facility.

Make a copy and have with you when you look at the record which will show who had ordered what.

Please look over your contract to see who is allowed to prescribe and exactly when you are to be informed.

Get a copy of all drugs your husband was on when he arrived. Find out when they were stopped and why.

I am really uncomfortable with what is going on.

Additionally carry with you a copy of the DPOA document.

Tell the facility when you will be there to meet with the NP and social worker.

such an excellent report, Brenda! Good for you, you were calm but determined, and stayed on topic. Be proud of yourself, and try to take a refreshing nap, too!

Whoa, M1 called it . This Doctor seems more interested in wielding power than "first do no harm."

I hope his orders don't cause behaviors to flare that cause the home to give notice and that the Director can advise if you can have another Doctor be primary. .

As others have suggested , it's time to start papering your contacts with this place. They document what they chose to in his file, sounds like you need to also.

Post visit/convo notes about what they've told you , things they were to get back to you on etc.

"As we discussed.. " " I'd like a clarification about …"

Don't want to end up in a "recollections may vary" situation and they have their version in writing.

Wow! I cringed reading the long list of meds and dosages for your DH. Did the doctor explain what each medication is treating/addressing? I see your DH is taking a very high dosage of Divalproex Sodium (which seems to be the miracle drug for my DH at 125mg 3x/day), but why was it prescribed for your DH? I sincerely hope this gets all sorted out for you and your DH.

For what it's worth, that's not a long med list really. Amlodipine and losartan are for blood pressure. Namenda and rivastigmine are for Alzheimer's. One could argue whether they are doing anything atbthis point but it's hard to discontinue them, if he's not having side effects. The Depakote, citalopram, risperidone, and trazodone are for anxiety and aggression. All reasonable. I guess the plan is to see if the Depakote and citalopram alone are sufficient to prevent recurrence of aggression.

That's good news overall Brenda. But…I'd still talk to the director. That's not acceptable professional behavior. Your feedback is very important.

We can't catch a break, can we?!