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  1.  
    Has anyone had any experience using Ambien for sleep for your loved one? My husband gets up many many times a night and usually falls out of bed as he struggles to get up. Neurologist prescribed Ambien but I have heard some pretty unfavorable things about it. Seems to me that giving a drug this powerful to someone already confused and unsteady on their feet does not make much sense. But maybe they just go to sleep and stay put and that solves the problem. But he usually has to go the the bathroom a couple of times a night. Will he sleep so soundly that he wets the bed or will he stumble and fall as he tries to go to the bathroom after taking the drug? Any ideas of how to help keep him from falling out of bed without restricting him to the point that he can't get up to go to the bathroom.
    • CommentAuthortrisinger
    • CommentTimeNov 7th 2008
     
    My non AD neighbor used it, and it did the weird things to her...strange dreams that seemed real, and conversations with people that she didn't remember.

    However, Andrea used it, and it didn't do squat for her. We even tried the Ambien CR. No difference. She was the kind that stayed up night after night, roaming about.

    As I understand it, Ambien is supposed to help you GET to sleep, and then it wears off rather quickly and you do your normal sleep stuff the rest of the night. Ambien CR is for those who have trouble staying asleep...it releases slowly over the night and keeps you down.

    But like I said, they'd never met Andrea, the non sleeping bull elephant. They hadn't made a drug yet that could put her out.
  2.  
    Our Dr. recommended NOT prescribing Ambian for my husband. He did prescribe xanax .5 mg for bedtime and it seems to work good for us. My husband gets up at least once in the night to go to the bathroom. Occasionally he gets his feet tangled in the covers and falls out of bed. I removed his top sheet and that seems to help.
  3.  
    I am really leery of the Ambian but I take Xanax. Maybe I could slip him one of them. I removed the top sheet of our bed too and that helped some but part of his problem is his stiff muscles and he has trouble sitting up so he rocks and he rocks to get momentum and then he just rocks himself right on to the floor. Sometimes pretty hard and I am afraid he is going to break a hip.
  4.  
    ehamilton my husband does the same thing for the same reason. I am afraid he will hit his head on the end table so I moved it back out of the way. The last time he took the mattress with him and we are not sure how he did that. I worry about broken hips too. He also takes flexeril at bedtime and that is a muscle relaxant, neurotin, namenda and aricept. Hope this helps.
    • CommentAuthorbriegull*
    • CommentTimeNov 8th 2008
     
    Does anyone else just use plain old drugstore sleep aids? I find that if my husband gets up in the night, to "go to the bathroom" which he does but his depends is already damp to soaking, I ask if he wants a "sleepy pill" and I give him one. It's diphenhydramine 25mg and it seems to work well. We're looking over the edge of the donut hole here and I'd rather not do more prescription drugs..
    •  
      CommentAuthorNew Realm*
    • CommentTimeNov 8th 2008 edited
     
    briegul,
    I'm surprised, but very glad diphenhydramine thus far works good for your DH. diphenhydramine is "Benadry." It is not recommended for older patients with dementia as it has a tendency to exacerbate confusion. There is a specific sumthinorother in the brain that it depresses. It stays in the system much longer than is desirable. I'll try to find out what that "sumthinorother" was.
  5.  
    --------------------------------------------------------------------------------

    A Re-Evaluation of Diphenhydramine-- Could This Old Drug Be Bad for Our Old?
    Recommendations of the Drug Therapy Committee
    Volume XII, Issue 8

    Steven M. Hernandez, PharmD candidate at the University of Rhode Island, wrote key pieces of this document and his contribution is hereby acknowledged.



    Diphenhydramine (Benadryl and others) is an older and presumably sedating antihistamine, widely used as a sedative-hypnotic, especially in the elderly. A recent event at the MGH suggests that the use of diphenhydramine for this purpose should be re-examined.

    A prospective study of the clinical use of diphenhydramine, conducted by Agostini et al at Yale University and New Haven Hospital, suggested the use of diphenhydramine might not only be problematic for the elderly, but for others as well.1 The indications for the use of diphenhydramine in elderly hospitalized patients in the study were:


    Indication Observance
    Sleep 68%
    Blood transfusion allergy prophylaxis 21%
    Allergic reactions 3%
    Not documented or other 8%


    There was a 70% increased risk of decline in cognitive function in the group that received diphenhydramine. The risks of cognitive dysfunction appeared to be dose-related, using the Confusion Assessment Method (CAM) and the Folstein Mini-Mental State Exam (MMSE). Other observations included increase in urinary catheterization (RR 2.5) and an increase in length of hospital stay (median of 7 vs. 6 days).

    Contrary to popular belief, there are no data to suggest that diphenhydramine is an effective sedative-hypnotic in the elderly. However, older patients are sensitive to the negative cognitive effects of the drug and to its anticholinergic effects, such as decreased alertness, dry mouth, blurred vision, increased anxiety, urinary retention and arrhythmias.2,3

    The Drug Therapy Committee suggests the following:

    Diphenhydramine should not be used as a sedative-hypnotic, especially in elderly patients.
    Many routine order sets list diphenhydramine as a "prn" medication. These orders should be discontinued from all order sets. The Drug Therapy Committee, after consultation with geriatricians, recommends oxazepam (Serax) 10-15mg as an alternative in elderly patients. Trazodone 50mg at bedtime is another choice. Other drugs, including other benzodiazepines, have been associated with significant cognitive dysfunction in the elderly. Zolpidem (Ambien) has also been shown to produce cognitive dysfunction and falls when used in this population.4
    Diphenhydramine should not be used for prophylaxis for blood transfusion unless there is a history of previous reactions. Because of the likelihood of side effects and the lack of benefit, this practice appears to be unjustified.
    The Drug Therapy Committee has approved the addition of fexofenadine (Allegra) as a non-sedating antihistamine for general use.
  6.  
    briegul I know what you mean about the cost. My husband is almost on the other side of the hole and will be next month so I am going to renew everything before January 1. Personally if I had been using the benedryl and it was not causing problems I would go ahead and use it. I have a friend who uses it
    for her Mother in the Tylenol PM and she knows it is not recommended. Costs can be prohibitive for many of us and I understand. I give my husband
    xanax and he used to use Lexapro. Both of them have generic but not sure of the cost. I gave my Mother Tylenol PM for years with no problems.
    • CommentAuthorbriegull*
    • CommentTimeNov 8th 2008
     
    yeah, I only give it to him roughly once a week when he wakes up at 11 pm or thereafter. And I take it myself more often than that. But it's good to know to be careful. I'm certainly watching out how much ibuprofin and naproxen sodium I take after that possibly being the irritant that gave me a month of diarrhea.