medication adjustments for agitation

Timmyd · September 3

DW and I were in a rather tolerable routine in our home for most of the spring and summer. She was generally pleasant and as cooperative as I could expect. I took a week of respite at the end of July and DW was cared for by other family members. I am sure they did the best they could, but it was clear things were happening while I was gone that were not optimal for maintaining DW's disposition. When I got back, agitation was off the charts and the situation was intolerable. PCP and I decided to increase the dosage of agitation medications she was taking and in the weeks following, things have since greatly improved.

Does anyone ever reduce the agitation medications after things have been improved for a while? Did the situation improve because we got back into our familiar routine at home or because of the increase in medication?

I know lots of people raise medication dosage to deal with increased agitation. Does anyone ever reduce dosage after agitation has been significantly improved for some period of time?

harshedbuzz · September 3

Behavior is communication. She isn't giving a "hard time", she's having a "hard time".

A couple of thoughts.

Most PWD settle back to a previous baseline of behavior/function within a week or so if they're going to do so. If there was no trend towards improvement in agitation with several days of your return, it might not be worth the experiment.

What do you hope to gain by reducing the dose? Are you looking to reduce side-effects? Avoid battles over taking medication? Reduce costs? These are all legitimate concerns that might be better addressed by a geriatric psychiatrist rather than a PCP.

What are the odds you might need to reintroduce substitute caregivers again? If you were to be ill or injured, it might be kindest for her to already have a level of medication on-board to avoid agitation.

It's a huge responsibility deciding on medication for another person.

HB

fesk · September 3

Yes. We have successfully reduced medication after a time. The doctor's opinion was the least amount needed in the system was best.

persevere · September 4

I think we all prefer less than more. It sounds like you did the right thing by increasing to get back to your baseline. My hunch is that both getting back to your routine and increasing meds helped. It wouldn’t necessarily be bad to try to throttle back to the original dosage. That said, we recently took one med out of the rotation and reduced another after DW started getting off track. So far so good. Sometimes these meds run their course.

medication adjustments for agitation

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