My mom lives in an assisted living facility and has been exhibiting angry/confrontational behavior with residents. The facility suggested we have her doctor prescribe an anti-anxiety drug. The doctor prescribed seroquel, an anti-psychotic. There is disagreement between my siblings whether this is a dangerous drug or not that dementia patients should not be taking (as written on the internet).
(((hugs)))
It's a lot easier to dope somebody up than to take the time to find the underlying roots of the problem. Triggers identified, you can formulate a treatment plan that includes both natural remedies and Rx medications.
Seroquel might alleviate -- if not mask -- the symptoms and help her relax, but what do you do when the effects wear off?
I'm hoping to talk to her dr on Monday, and see if I can get her into a gerontologist that specializes in AD/dementia asap. But before that, I'm going to halve her 6PM dose, or I'll never even get her a much needed shower! I feel so bad for her, but glad she's unaware of just how much she's changed. Two years ago she was on Celexa for anxiety, but it eventually backfired; hence Seroquel.
Thanks again, I know my husband & I will work out some time with our extended families...just had a tough moment! ;-) Merry Christmas to you & yours! ♥
Your mother's new levels of agitation, sleepiness, etc. could be a result of the drugs she is taking. This started, I understand, before the increase in the Seroquel, so presumably it is not totally a result of the increased dose. How long will it be before you can consult her doctor? Is there a nurse line provided by her clinic or insurance that you could call and discuss the situation with? I don't think that this is a drug you should stop cold turkey, but a knowledgable source may be able to advise you about a reduction until you can talk to her doctor.
The changes in her behavior could be related to something else that is going on in her body, such as a uti or low level infection of some kind.
And the changes could be the progression of her dementia. Dementia by its nature gets worse over time. Perhaps that is why the doctor is trying a higher dose of something that seems to have been working well.
Diseases of the mind are extremely hard to manage. And we all feel so helpless when our loved ones are suffering and we don't know what to do. Ultimately the disease will win. The goal is to maintain as much quality of life as long as we can, and to optimize comfort and minimize distress. Know that you are doing your best.
I hope that you can talk to a medical professional now, and to see her doctor soon.
Sit in her room, hold her hand, enjoy some holiday music together. Again, hugs to you.
If your doctor does not know what Beers Criteria is...get another doctor. it is the protocol for getting the elderly off drugs, getting long-lasting versions rather than quick acting, etc. Mom actually did not need this drug in the first place, in retrospect. She just did not understand her GERD symptoms and was delusional she was dying...felt like heart problem. Unfortunately, the doctor replaced with Ativan, and that caused other problems. Eventually, we got her off every single med and she has no hallucinations nor delusions. Live and learn, at Mom's expense...and tough caregiver job.
Hang in there...
Recently she began exhibiting much anxiety, agitation, sneaking outside, hearing voices telling terrible stories, seeing awful things, talking to herself all night, etc... So the dr added one more Seroquel at 6 pm, and the other at bedtime...however bedtime (a week later) is earlier, like 8pm. It's increasingly hard to get her out of bed, or out of her room, not dressing, no interest in anything but looking out the window. Isn't hungry, getting harder to get her to eat anything, "It tastes bad!", will hardly drink water, weak & tired, constipated some, just wants to lay down all the time.
So here I am, Christmas weekend...looks like I'll stay home to monitor her. I wanted to get her shower, but it's not looking likely! I'd like to cut back on this even before contacting her dr. Any more thoughts from y'all? Such a rotten disease!
I think factors that need to be considered is how serious are the behviors that are being treated and what are the alternatives? Are there potential remedies with less risk? Have they been tried? If you have simple depression (not, for example, bi-polar disease) there are certainly other things to try without resorting to such a powerful drug. The same is true of typical insomnia.
I gues all of this is pointing to the importance of dealing with a doctor who understands the particular conditions he or she is trying to treat, and understands the risks and benefits of any drug being considered.
Antipsychotics in general may be overprescribed, especially in nursing homes. That does not mean they are never justified and never the best choice.
I'm not sure what they called it when she was in her 30-40's when I was first
exposed to it, but It's about the same behavior except she doesn't threaten us
anymore. Psychiatrist prescribed Celexa, an anti depressant, for use during the
day to try to wean off Seroquel. I have noticed an involuntary twitch that I read
was a side effect of Seroquel. Mother's Geri psych says it is effective in the lower
doses. Psychotics are prescribed 300mg and up! The doses given elderly are very low! (God please have mercy on us.) hugs, Christina
My bipolar brother also takes Seroquel, also as a pre-bedtime medication.
I have also heard from other CGs whose loved ones have the same diagnosis as my husband that Seroquel was not effective, or that it even made matters worse (which stopping the drug solved.) When treating disorders, ESPECIALLY problems in the BRAIN, what works magic for one is a nightmare for someone else.
I would ask, how qualified is the doctor you are dealing with to treat the condition your loved one has? Can you get a second opionion from a specialist if that is appropriate? Is the doctor going to start with a very small dose and instruct you what to watch for by way of side effects and effectiveness? Is he or she going to approach this as a "trial period" and be willing to stop it and try something else?
WIth any drug there is a risk it won't work or it will temporarily make matters worse. And it is true that some LTC places overmedicate for their own convenience. For this reason some people shy away from drugs. I am a huge fan of drug treatments, carefully thought out and slowly, watchfully administered. Better living through chemistry is my motto! :) I saw what my husband was like without drugs, and what a huge positive difference they have made in our lives.
Be cautious, Sunshine. But also be brave!
Anyway, the point was, all drugs have the potential for nasty side effects, especially drugs that alter brain chemistry. However, when someone starts to exhibit angry, confrontational behaviour, it can be very distressing not only for the people around that behaviour, but also for the person exhibiting that behaviour. People with dementia may well be aware that their behaviour is changing & may be embarrassed & ashamed of their inability to control their behaviour.
Unfortunately, using anti-psychotic drugs, mood stabilisers, anti-depressants etc, can be a bit of a gamble. There is not a lot known about how these drugs work, but we do know that they DO work...not for everyone, but they DO work. Sometimes it's a matter of trying a few different ones until the right one is discovered. It's not a very precise science.
If you're going to go down this road, just be sure that your mom is carefully monitored for changes in her mood, behaviour, also blood pressure, other vital signs, relevent blood tests (for example, liver function needs to be monitored with Depakote) & you need to be able to trust the doctor. If not, get a second opinion. Also, be sure that other methods of behaviour management should have been tried before going down the medication road. Ask the facility what they have tried. If you haven't already, perhaps get in touch with a dementia support group to see if you can get some education about behaviour management in dementia care.
Good luck
Please be careful with the Depakote, I've taken both for PTSD and I would not recommend either. But....I don't know what dose your mother will be taking, her health status or how old she is. If she needs to gain weight it will take care of that.... and some people lose a lot of their hair (I didn't though).
God Bless
But you know what, they (doctors) don't done KNOW nuttin about all this. It seems to be a big crapshoot, with our parents as the guinea pigs and "there are no medications without side effects" and"part of normal Alzheimer's decline" as their impunity shield.
As much as I eventually decided to X the Ativan, it could be useful for knocking back weird behavior once the patients starts on a rant. the pills are so small, that a half a pill would do a lot, even quarter.
I at first assumed I should use it regularly to stop attacks before they even began, and dished it out a half pill at bedtime, and a quarter in AM. And for awhile it quelled outbursts. And then and then and then...
Just to let you know that this Ativan can take effect in about a half hour. My ER intake-desk nurse niece said that they used Ativan to calm relatives who had someone die in the ER.
However, if the patient is already upset, good luck getting any kind of pill or food down them. I keep it on hand just in case, and darn if there is now no "case." for now...who knows what the next day will bring.
Glad to know about Depakote. There was a funny (written in joking style) report about the side effects of that drug on one of the reporting sites. Said it would make you an instant elderly person. Would of course read up on it totally before I had mom get on it.