Meds for Anxiety/ Agitation

beachwalker5 · October 23

Sorry for this long-winded posting, I welcome and appreciate any and all responses.

My DW is 79, diagnosed with AD earlier this year but started showing signs 3-1/2 yrs ago, currently probably stage 4? She can still handle most of her basic ADL's but no longer drives, cooks, pays bills, etc.. Her anxiety/ agitation/ emotional outbursts and general "altered states" are recently getting more pronounced. She also suffers occasional delusions but I find these to be less difficult to manage than the anxiety/ agitation. I've consulted "The 36 hr Day" as well as other references for non-medication suggestions for managing her challenging behaviors, and have tried most of these non-med suggestions which are hitting their limit of effectiveness. Her neuro's office staff has told me that he typically prescribes a low dose of Seroquel for his AD patients who exhibit the behaviors that my DW is suffering and I'll be requesting (via a pre-appt. note) that he do so when we meet with him in a few weeks. Getting the meds into her will likely be yet another new hurdle.

An additional recent development is that I'm finding it really difficult to leave my DW to get a haircut, attend to car repairs/ maintenance, go to my own dr's & dentists appts. or just take a solo mental health break to have lunch with a friend or attend a support group meeting. My DW isn't "wandering" yet but I'm still worried about her safety when I'm away as well as her frantic phone calls minutes after I leave (WHERE ARE YOU?????!!!!). My relatives and a few close friends are all encouraging me to get outside P/T home care help. They are all very worried about me.

A few questions for my fellow travelers here:

What are your experiences with meds controlling your LO's anxiety/ agitation/ emotional outbursts and general "altered states"? I don't need specific drug experiences or recommendations, just general experience (meds vs no meds). Are you glad they got meds? Do you regret it? How long did it take to find the best med and allow it to kick-in?
Any advice on best methods for getting your LO to take the meds, particularly if they are resistant? My wife has been very compliant with her neuro's treatment of her amyloid plaques thus far (Kisunla infusions, brain MRI's (which she HATES!)) so I'm hoping his prescribing med(s) as part of her overall treatment will mitigate her resistance.
I'm assuming it is best to get her anxiety/ agitation/ emotional outbursts and general "altered states" under control before introducing the new variable of an outsider coming into our home to care for my DW two or three mornings or afternoons a week? Do you agree or should I consider getting help even before or during the period that she is adapting to a new med(s)?

If you made it this far, thanks for reading! Hang in there fellow-caregivers!

dcare45 · October 23

In the beginning I was kind of against meds in general. I feared DW would zombie out. After I realized how difficult it was for DW to be constantly anxious and frustrated I changed my mind about them. They have helped immensely. She did not zombie out. It took a couple months at least too get the right mix. She does not like taking meds so I crush them and put them on PBJ toast or anything DW likes. Make sure you check with a pharmacist or Docs to make sure they are crushable some are not. Yeah I think you stand a better chance of having help accepted if you get things calmed down first. Good luck

blacksparky · October 23

I also didn’t use drugs but as my DW’s disease progressed, I made an appointment with a Neuro psychologist and we started her on some low doses of different meds until we found the right one and dose. This took about a month or so. My DW has always taken vitamins so I just tell her it’s time to take your vitamins and she does. Make sure you always check the cheeks and under the tongue for pills not swallowed. This disease is just trial and error.

SDianeL · October 23

medication is necessary to control anxiety & agitation. A Geriatric Psychiatrist is the best type of doctor to manage them. The trick is finding the right meds in the right combo. Don’t let her continue to be anxious. As others have posted, you could try fibbing. I told my DH that his doctor prescribed it to help his brain. Ask the doctor for meds that can be crushed. Your DW should no longer be left alone for any length of time. She would not know what to do in an emergency. She could start a fire or get injured. Get outside help know. Although she has not yet wandered, she could do so at any time. Tell her the help is for you for light housekeeping. Tell her you need it. That worked for me. The first time the aide came I stayed home and went in another room to pay bills etc. The second time I left for a hour to see how it went. The next week my DH asked if “my lady” was coming to visit. 😊💜

fesk · October 23

https://alzconnected.org/discussion/77407/meds-for-anxiety-agitation

This is a very difficult phase to navigate. I always rule out any medical causes for behavior - UTi, other infection, etc. before contemplating any medication. Behavioral approaches first too like you mentioned. Antipsychotics are a medicine of last resort for me. They carry many, many side effects, can worsen cognitive issues, etc. When behaviors were becoming an issue for my mother, I requested alternatives to antipsychotics. My mother did well for years without taking antipsychotics. She did eventually need them at one point, so the least amount needed was used. Also, you may want to consult a geriatric psychiatrist who may better be able to manage the intricacies. All medicine - antipsychotics in particular - need to be handled very carefully. In my opinion, there's no reason for the person to suffer, so if medication can alleviate that, I have no issues with it. The only regret I have is having to use a medication that had undesirable side effects because other medication wasn't effective. Unfortunately, there isn't always a good fit.

Taking medication wasn't an issue for us but, as mentioned, if the pill can be crushed, it's helpful.

The right aide would work with you as you're dealing with behavioral issues but they are few and far between. You would need to be upfront with the agency so the caregiver knows what they are walking into. The caregivers will not deal with anyone who may harm they though. So, if that's an issue, you may need to wait. From what you have described, it doesn't appear your wife is safe to be left alone anymore.

I wish you the best of luck.

Meds for Anxiety/ Agitation

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