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For OP - given AD, you'll have to work with his doctors. Hopefully there is a specialist involved, not just PCP. They can recommend the best treatment (for someone without AD, one could try counseling, but that doesn't work very well for those with any kind of dementia.) Talk with pharmacist about any medication suggested - they know more about meds than most doctors. They would also know what to watch for (the paperwork lists a lot of issues, but it may not catch them all, so do some online lookup too!) Be sure to check my final thoughts below regarding UTI - it could be important!

There is no "one size fits all" in medication and no way to know beforehand if medication will cause a problem in any specific person who takes it. Some medications work for some people, even those with the same affliction, but other times doesn't work for others who have a similar issue. Some medications help a bit, while some/same ones cause more problems. It may become a trial and error before you find the right one.

Work with his docs to see what might work. Depression is a terrible thing and if there is any way to alleviate it, I would change my tune (I also prefer not to take medications unless there is no other option.) Monitor him carefully when he starts on any medication and consult with doc/pharmacist before stopping them if there appears to be an issue (some medication require "weaning" off rather than just stopping them.)

They used an anti-anxiety when we moved mom to MC, but only 1 Rx, no refill. Later we did have to get it again, minimal dose both times, during a UTI which caused some serious sun-downing for her! The nice thing about this med is the results are first time, every time, and no need to wean off it, plus it was just enough to take the "edge" off, not dope her.

Now that I mentioned UTI - it sounds crazy sometimes when we mention this, but DO have him checked. UTIs in elders, and esp those with dementia, cause some really odd manifestations!!! Mom's first UTI at MC was the sundowning. Second and third, nighttime bed-wetting!!! After UTI was treated, all was good again!

FROM:
https://www.alzheimers.org.uk/get-support/daily-living/urinary-tract-infections-utis-dementia

"If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI."

Withdrawal maybe part of this depression he's having? When you ask for UTI test (you can start with a home test), be sure to request a culture test, not just the dip-stick test.

BTW, when I first joined this forum and read so many suggesting test for UTI, I was skeptical... until it happened to my mother. DO take this seriously. It may not be UTI, but it is easy and quick enough to rule it out!!!
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You are not specific about what signs he is showing. With Alzheimer's, it's like someone's mind gets unwired. My mother has it and she has had a slow decline from being a smart, capable and creative person to someone who needs total care, like an infant. She was having anxiety and not sleeping well. Her doctor prescribed Melatonin, which has no bad side effects and calms people down. She takes it every day. Talk to his doctor about whether stronger medications are recommended.
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Everybdy , pleasectry to rememberthat nobody; absolutely nobody has ever had a happy and painfree life. that just does not ever happen.We live in a cursed and fallen world. However, it is a world that does still have some of the beauties and joys God originally gave to it. Also, with his help, we can overcomethe many adversities at least partially.We can avoid a lot of suffering just by never evervtaking statins, antidepressants, strong diuretics,or any other dangerous things.Also, wecan help ourselves a lot by taking sublingual B12 every day and eating a lot of magnesium rich foods every day.Just try it. You canlose nothing by just trying really good food and extra sublingualB12.These things cannot possibly harm you.Eating a whole egg every day and drinking milk or eating yogurtvdaily can do no harm either. Just try it. You may be surprised. Remember, it has to be daily.God bless you every one!
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theguardian Apr 2020
Amen!
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My whole goal for my Elderly Mother with FTD, is to do everything that I can to make her life pleasant.
She starting with the depression, the beginning of the third year. Was grumpy, complaining, negative. Her traveling nurse recommended that I try a low dose antidepressant. We did it on a trial basis. She started with 10 milagrams of Celexa, then
over time went up to 20 mg.
It has made all the difference in her mood, also reduced her high anxiety. Takes several weeks to kick in. It was a God send for her!!
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If any medication will help - RX or OTC - then imho, they're available to help. Not all will agree.
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Depression is common in people with dementia. I'd suggest first speaking with his PCP who hopefully has already started him on Aricept or another medication for dementia. If he/she isn't sure, I suggest taking him to see either a geriatrician or a geriatric psychiatrist. The latter would probably be your best resource of all. Why allow him to be more anxious, upset, or depressed if a simple medication can help this condition. Dementia presently can't be cured or for that matter, even very well managed for long periods of time. Now depression, that can be controlled with medication and/or psychotherapy to the point that it is very well controlled. Please note, just because an individual is started on an anti-depressant doesn't mean they will need to continue on it for life. If your husband has never had issues with depression before in his life, he may only need to be on the medication for 6 to 9 months and then he can be tapered off of it. Though considering he also has the dementia diagnosis, if he's feeling significantly better on the medication and there are no or minimal side effects, you may want to just let him stay on it. Why be miserable when there are medications and treatments that have been proven to help this condition? Lastly, if you are so totally against medication (I'm assuming you mean medications in general and not just medications for depression.) and your husband feels (or has felt this way in the past) the same way, there are herbal medications such as St. John's Wart and SAME (I think, might also be a number with that.) which are available over the counter or at a nutrition store. I would advise just as with starting any medication, consult first with a health care provider (not including the "specialist" in the nutrition store). A naturopath or ND is a doctor with medical training who prescribes only herbal-type medications. He/she may be able to offer help w/o the use of traditional anti-depressants. Personally, I encourage my patients and/or family members and caregivers to try. The best thing that can happen is a desired result and (short of taking an overdose), the worst thing is that the patient develops intolerable side effects or there is no change in condition and you're back to the drawing board and the medication is discontinued. PLEASE note, anti-depressants should never be stopped abruptly except under the advice of a health care professional as a rebound effect can occur and this can be very serious.
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I have no advice, but I get so dismayed with the NO PSYCH MEDS EVER stance, and I see it often on here.

People are still so afraid of meds, and in some ways I understand. Psychiatric treatment alone in previous generations was regarded as something for the truly crazy... people on the streets who mumbled to themselves, or criminals.

Meds of the 50s, 60s and 70s are not how they are today. No legit doctor wants to make their patient zonked out for days. The goal is not to make someone numb or drooling in a corner. Not all meds are meant to tranquilize.

Say you get a bad cut on your leg. It starts looking a little infected. The doctor looks at it and says you need antibiotics or you're risking gangrene. Would your reply be, "Nope! I'm gonna tough this out! I don't believe in those meds! That's for weaklings and I can fix this on my own!"? Not likely.

It's the same with psych meds. If you seek help for a physical problem, no one would bat an eye. But when someone needs help for a mental problem, ooooh no. Can't talk about that.

Something has gone awry with brain chemistry and the meds can help level them out. Doesn't change who you are. Doesn't make you weak. Doesn't make you a druggie. The brain sometimes needs help to "heal", and it's no fun for the depressed person to feel crappy either. Why would anyone just automatically refuse the help they need?
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You may be anti medication which is of course your personal choice but it really should be that choice for you. Depression is very encompassing. Aging of course is not ideal to put it mildly. The 2 together are difficult. If your husband might be helped by an antidepressant then I think you owe it to him to consider that.

There are numerous antidepressants available. If a doctor reviews the symptoms your husband is experiencing there might be one that could truly help him. Wouldn't you want him to feel better if possible? That should take precedence over your views regarding medications. He may not be able to make this decision at this point on his own. Putting your views of medication aside you could help him find relief possibly. You govern your own body but another person has the right to get help if possible. Hopefully a doctor could help you with that decision.
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Would you give your husband medication for an infection or diabetes? Mental illness has biological repercussions. (I was going to say causes, but honestly, I'm not sure if the depression causes the biological changes or vice versa. But there are definite biological changes associated with depression.).

If you believe medication can help with physical problems, please don't discount their value with psychological problems.
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I am sorry that your husband is depressed. I think it’s absolutely normal to get upset over legitimate concerns.

I really dislike ‘Pollyanna’ personalities. Sorry but it really works on my nerves when a person has a legitimate reason to be upset and there is a Pollyanna type person nearby with a ‘fake’ smile and doesn’t have a clue as to how this person feels. Depression is certainly real, as are many other things. There is confusion and misinformation about mental health issues.

Unfortunately, some people simply do not understand something if they have not experienced it themselves. Some people think kids with dyslexia or attention deficit disorder are daydreaming or misbehaving. They referred to them as ‘slow.’ They think people with depression need to pick themselves up by the bootstraps and carry on. They think people can eat well, exercise and take supplements and they will be fine.

While eating well, supplements and exercising is great, it isn’t a miracle cure. Sometimes depression is situational. Sometimes it is a chemical imbalance and requires medication.

There have always been stigmas concerning anyone out of the ‘mainstream’ zone. It is ridiculous.

If a person needs to see a psychiatrist, psychologist or social worker, they should go. If they need meds, they should take them. Please let’s erase the stigmas attached to these issues. This is 2020! We shouldn’t have to still be discussing these issues anymore.

Everyone needs an individual assessment of their personal needs. There isn’t a one size fits all ‘fix’ for everyone.

Do what is right for you personally! Do what you and your doctor feel is right, not what the neighbor says, not what people on a forum say, but what has been decided with you for your husband by professionals. They have extensive experience and knowledge about how to treat these situations. You need to do your part by giving feedback. A psychiatrist can’t make necessary adjustments in medications or lifestyle if they don’t have feedback from the patient or their medical POA.

All the best to you and your beloved husband. You are so sweet and thoughtful to care so much for him.

Please do self care as well. Do not neglect yourself. Patients are struggling and special. Caregivers are special! Everyone matters.
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BlackHole May 2020
Yes to all this.
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My dad is on Effexor and it's helped him tremendously. Just do your research and talk to your doctor. He did not want to take medication at first and felt like you do, but is now convinced that it's helped. What do you have to lose?
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