My difficult 89-year old father, who has life- long inappropriate anger management issues and agitation, was put on Risperidone two weeks ago because he was becoming too unmanageable for me. I live with him in his house- I have POA and there was also something about having to live with him for at least two years, and he couldn't live in the house by himself. It has to do with protecting the house, depending on how things went. Hopefully this two-year deal will be satisfied sometime next year but I will have to get a refresher from the attorney before I make any changes in our current living arrangement, where, either he goes into a facility, or I move out. But I definitely am thinking about it! Anyway, he is an alcoholic in denial but was being pretty good about not consuming much alcohol for 4 years, after a falling incident, but has a renewed interest in it again. With our current arrangement, I have no control over his purchase or consumption of alcohol. I don't think that there is any way to keep him from it unless he was in a secured area of a facility, and I don't know about the requirements for obtaining that. Today, about a half hour after giving him the Risperidone, he decided to have a beer, even though I told him that he wasn't supposed to have alcohol with it. He was his usual hostile self and told me to shut up. I am wondering if I should give him the 2nd dose this evening or just stop it altogether. In the two weeks that he has been taking the Risperidone, it has helped him sleep through the night but it has done nothing for his anger, agitation or behavioral problems. And since I am responsible for giving him his meds, I am uncomfortable about the potential issues if he insists on having alcohol. As usual, it always seems like these kinds of things happen on the weekend when clinics and the like are closed. We were supposed to see his Dr during the first week in January to talk about the med. I am wondering if I should just stop giving it to him. And also whether his Dr will even keep prescribing it if she knows that he is drinking.
Then I would strongly suggest you talk to the doctor that is prescribing the medication about the way it is and isn't working. Sounds like you not only have your hands full but come close to the edge of it being dangerous and that is not ok. Even if he was a mean drunk in his younger, healthier years it doesn't mean he knows what he is doing now or can be counted on to behave the way he always has and it seems to me there are probably other medications that might help if this one isn't and it might be worth talking about something that deters him from drinking if that's going to be or is a problem. Hang in there!
Unless the patient information leaflet says different (you can find it online if you don't have it to hand, make sure you go to the manufacturer's own website and look up the exact formula he's been given), continue to give the risperidone regardless but contact the prescribing physician at the earliest opportunity to explain the problem and get new instructions. You may find it helpful to keep an accurate record of how much he is drinking until then, but do make sure it is accurate.
If you Google "Risperidone and alcohol" you will see many pages of advice. Print off a few, not more than three or four, from reputable sources and give them to your father. He is a consenting adult. You have given him the information. If he ignores it, on his head be it.
If you see him in the act of getting into his car to drive while he is intoxicated or visibly sedated, call the police.
On your father's driving, call your local DMV and ask what you need to do to report an incompetent elderly driver. I had to write a letter to them stating my LO's problems and close calls. They contacted her and she had to take another driving test. Somehow she managed to pass it; if she had had to take the written test she would have failed. They did put restrictions on her license. Soon after that my dad traded in their car for one with all the modern bells and whistles and she wasn't able to figure it out so that fixed the problem.
If you have questions about a medication on a weekend, don't forget that the pharmacist at your local drugstore has a lot of knowledge about the side effects and interactions of drugs. It would be best if they would speak with your father about it, but you can also usually get a handout from them that is easier to understand than the package insert. It really helps if the pharmacists where you go get to know you.
This week, he has purchased 5 bottles of wine and I saw him drinking both red and then white this evening. He absolutely will not talk about it...he insists that it is good for him and of course is in total denial of his history with it...the decades of being drunk before noon, the numerous falls and scrapes in the yard, and then the fall and concussion in the parking lot after having driven with my late mother in tow, or the delirium tremens in the hospital where he had to be tied down. And he is still driving, had enough mishaps WITHOUT the alcohol, and I don't know what to do about it. I might give the police a call to see if they have any ideas. And I really can't take the alcohol or his car keys away without assistance. But I have no backup from my siblings. One lives halfway across the country, and the other one wants nothing to do with my father...unless there is any $$$ left to inherit, of course!