Meds for people with dementia

My dad has never been combative and takes no medication. However if my situation is what you’re describing I don’t think there is any way I would accept this, especially not after two hospitalizations.

I am on other boards where what you describe is common, repeated hospitalizations and it can take many tries to find the correct cocktail but eventually they usually find something that works. I don’t see how you or your mom live like this without medication. What does your psychiatrist suggest instead?

As for what meds, IMO no one here can answer, every PWD is so different.

Is the psychiatrist reporting the same behaviors that you are? Does your mom have any health conditions that makes them think they couldn't try one of the commonly used medications? My mom's psychiatrist at MC didn't often see my mom's extreme behavior (aggitation, confusion and delusions). We experience(d) them every visit and mom's care team did as well (and was documented in her file). For some reason mom was able to hold it together for her psych visits enough that they didn't want to introduce any anti-psychotic drugs. My mom had a hospitalization last month and the geri psych doctor there introduced Seroquel which she was doing very well on. For some reason she decided to refuse it now that she's back at the MC. We've been told that if she experiences another crisis that she would need to go back to the hospital. We worry that if she refuses it again that she would not be able to go back there because her behavior was extreme. I know I would rather be medicated than upset, confused, paranoid and angry. It's so difficult. Sending you well wishes.

It’s true that meds are person-specific, but one MC director I met told me she often saw good results from some combination of Lexapro and Seroquel. Another mentioned Buspar for anxiety/irritability. Has the psychiatrist spoken with your MC facility about their concerns? Maybe requesting some collaboration there could be helpful. Your situation sounds very frustrating and I really hope the doctor will figure out a way to help - good luck.

Can you ask for a second opinion in house? The current Doctor may be making your Mom 'showboat' or has a bedside manner that calms her down.

Does she act up when being fed or cleaning up? If the Doctor is in the room when her guard is down during these activities and she feels the mental pressure of having to be touched or asked to turn , etc maybe they will be getting a better idea of her behavior range then a soothing ' And how are we today?'

I know of a family who just automatically medicated their father at 4:00 every day because that is when he started to sundown and his behaviors became unmanageable. I would not want to do that. My mother would have episodes of extreme agitation, wanting to go home among other things, and we have her on Buspar now. I'm not sure how much it helps. She has started having episodes of extreme agitation which includes sobbing, rejecting us, almost hysteria, the PA has prescribed Xanax. It is very fast acting, I just have a problem with medicating her too frequently. We did get her to take it once and it helped. For me, it is the solution of last resort. She is mentally uncomfortable and difficult but I'm hoping we don't have to medicate her on a regular basis.

Thanks for listening.

Memantine 5mg twice a day worked for my mom in the middle, agitated, fearful, hallucinating, paranoid stage. Calmed her down considerably. Now in late stage, more stable though less verbal. On memantine 5mg once a day. Hang in there!

I think most of these types of meditations can take at least a week to a month to take full effect. If the dose is increased (it’s done slowly) and then the meditation is eventually determined to ineffective, the dose must be tapped down vs just stopping. If a new medication is started, the whole long process starts all over again. I think it took at least 6 months to get mom’s medicine figured out. It was really hard on her. It was a bit of an emotional roller coaster. I hope they can figure something out for your mom.

It can take weeks or months for an antipsychotic to help control behaviors. Increasing too quickly, switching between different medications too quickly can all cause issues. There is guidance on how exactly to taper off these medications before starting another. There are also rebound symptoms when stopping these medications that mimic the original symptoms they are being taken for.