Do any of you have experience with Geodon? My husband is on 20mg twice a day. When I described his aggressive and abusive behavior to his dr in Nov he was prescribed haldol .5mg, later upped to 1mg when the lower level did not change his behavior. At our visit last week, I commented on his increased sleeping and the change in his gait to a bit of a shuffle. So now we are on Geodon. According to data sheets none of these anti-psychotic meds are recommended for older adults w dementia. He does seem a bit more lively and has stopped going to bed at 7pm. I guess it's a matter of balancing meds and behavior. He has been on 250mg Depakote ER since December. BTW, Depakote ER just became available generically.
A year ago, DH broke his hip. While in the hospital, recovering from the surgery and anesthesia, the hospital doctor put him on Haldol.
About 2 months after we returned home, we had an appointment with his Neurologist at Baylor. She was appalled that he was on HALDOL, and said they NEVER use Haldol with Alzheimer's patients and not to "allow" anyone to put him on that again! I called her office from the hospital and hoped she would coordinate his hospital care with his Orthopedic surgeon. OF COURSE, they declined - as they did not feel a need to work with an orthopedic case/care. Later, it's "HOW COULD YOU HAVE ALLOWED THEM TO PUT HIM ON HALDOL?" I do believe, we as caregivers should have an MD or at least a Pharmaceudical degree. We're expected to keep all of the drugs straight, be informed about black box usages, off lable use (Aricept twice a day)..etc. I want a diploma in a frame.
My DH is on Geodon--40mg midday, 80mg at night. This was the 4th choice out of 5 to replace the Thorazine he'd been on for over 18 years. Seroquel made him sleep. Zeprexia (sp?) may as well have been water. Risperdal was wonderful for the mental/dementia issues but had him at the Orthopedic Specialists for joint pain and muscle stiffness. I don't recall the name of the 5th choice but was told it would require very close monitoring and nearly continuous blood tests. Any lower dose of Geodon for him leavs him agitated and irritable. Ditto if it's upped to what I was told is the "normal dose" er day. My reaction to that is "How about what the patient needs not the calendar or clock." When he first went in to the hospital, before they decided on the actual med changes, they had him on Haldol for a ouple days. What is it about Haldol? The threw my Mother-in-law on it for a while at first when they knew her issues were damage from a stroke. Seems as though if the patient is agitated they throw the Haldol at them to knock 'em flat. Some treatment.
Hey, Nancy B, that's a great idea for a new product for Joan's store ... an official diploma for an advanced caregiving degree, framed and suitable for hanging!
My DH has been on nearly every medicine mentioned on this website, including Geodon. It didn't really help my DH. Among other things, my DH is now on Risperdal .5 mg and Seroquel 300 mg.
The doctors can't seem to decide what he has. :-( We are going to UTSW tomorrow. They have an AD research group. I found it from a link on this website. I am, once again, hoping against hope for a diagnosis.
According to my DH's neuropsych eval in September 2008, my DH has severe executive dysfunction and memory impairment. He has also had a significant personality change (to very quiet, not aggressive or angry). Oddly, his naming ability has been more preserved than other areas of the brain (though he has been having more problems with it lately). The damage is more on the right side and "anteriorly" (whatever that means). My DH also has myoclonic jerking and Central Sleep Apnea that became remarkably better when the Namenda & Aricept combination got to their full effectiveness (down from 33 episodes an hour to 8).
They originally put my DH on Risperdal in December of 2007 when he had a psychotic break (completely lost touch with reality - not oriented to time, place, or person). I believe the psychotic break was drug induced (a combination including Wellbutrin) because he started coming back to reality when they removed Wellbutrin (after removing several others). My DH was having serious hallucinations - both seeing gremlins and hearing voices. They had him on 4 mg of Risperdal (a high dose) because it took that to get the hallucinations to go away. Then, after about 4 or 5 months of having him be very "flat," I talked the psychiatrist into start taking him off the Risperdal. We dropped the Risperdal down slowly at one month increments. When we got the Risperdal down to 1 mg, my DH started jerking and hearing voices again. So, we started adding the Seroquel. It took 900 mg of Seroquel XR to eliminate the voices. With that, we were able to reduce the Risperdal to .5 mg. We couldn't remove the Risperdal 100% because my DH's myoclonic jerking became too bad and his full body jerking started again. He is still having myoclonic jerks, but they are within acceptable limits. We have now reduced the Seroquel XR to regular Seroquel and he takes 300 mg at night. When we dropped it to 200 mg, he started having too much trouble sleeping (too much movement).
Probably more information than you wanted to know, but it might provide some insight. Who knows, the cluster might trigger someone to help me know what form of dementia is likely (FTD, VAD, AD ...).
Please say a little prayer for our visit tomorrow. We really need a firm diagnosis.
I'm also very interested in what you are going to find at UTSW. They have a good reputation there. I just hope they don't have to go through another long battery of tests, MRI, Lab work, etc. That takes forever. I know how much you want a diagnosis..so you can get on with it.
Sharan, you are so "on top of things". I believe in going in with every report, drug record, and dates of everything..(which they insist on knowing) ... because if you do, they will proceed. If left to them to obtain this info.,... they will take forever. I insist on copies of every report and radiology report for my file every time.
Doctors will pay more attention to patients when they come in with data like you have. It is a "team effort". I've been complimented on coming in with this information...and it feels good to know that someone appreciates our efforts...
My pcp has complimented me on bringing in a written report on current events in dh condition. I let him know complaints, meds, and concerns. He keeps the paper in the file.
Do you often feel that we know as much about AD as PCP's know, if not MORE? Certainly, our Neurologists know their business, but PCP's are best for colds, flu and routine check-ups. I had a great PCP who would refer us to specialists if he noted a particular problem.. So many older docs have such big ego's..they want to stay 'in charge' of everything. The younger docs are more apt to refer us to specialists.