hi, i have logged in in awhile,my computer has been down. my dh has been having a terrible time with crying and praying to die. things were just getting worse and worse. he has been doing this for some time,but then things would get better for awhile. i never knew when it would hit him and it has just been terrible. he had been really sad and crying for almost a week,i was so terrified he would take his life. our app. with his neurologist at vanderbilt isn't until july 7th and they could not take him any sooner. i knew something had to be done for him before that. we made an appointment with his neurologist closer to home. i talked to dr. outside of examining room and explained how things were going. he has trouble dressing himself sometimes,the sadness,wanting to die[he fought with one of his brothers and told him he would kill him,this was the first time for something like this,he has always been so easy going] dh takes trazadone, [for sleep] xanex, [for anxiety],razadyne [for ad]keppra, [for seizures] lexapro, [for anxiety] celebrex, [for arthritis] and meds for his stomach,since celebrex upsets his stomach. dr. increased his trazadone and told me he was on a very low dose,he uped this to 100mg and explained this could also help his mood and have a calming effect. he also put him on abilify 5mg daily to start off with[1/2 in morning and 1/2 at night] i had never heard of this medication before. i can not believe the difference in him already. he has only been on this new med and larger dosage of trazadone for 1 week and it is like a miracle,so far. this med is usually given for halucinations etc. but it sure has helped him. dr. said it would help to mellow his moods. it has been a god send i. i hope it continues to agree with him and help him. he has even commented several times,that he feels better. dr. said this medication would not make his memory worse. i wanted to tell you all about this,in case some of your loved ones are in my dh's situation and could not control the sadness and crying and wanting to die,maybe this medicine could help them too. i will let you know,as time goes on,how things are going with this medication. jav
I Googled Abilify. It is a new drug used primarily for Schizophrenia. It is also approved for treatment of major depression and bi-polar disease, but one paper I read states that it is not approved for people with dementia-related psychoses. Here is the exact warning from the package insert:
"The safety and efficacy of ABILIFY in the treatment of patients with psychosis associated with Alzheimer’s disease has not been established. If the prescriber elects to treat such patients with ABILIFY, vigilance should be exercised."
In this case I would weigh the benefits (marked improvement in his moods, etc) vs. the potential risk. Most of the risks I could find were in the range of less than 1 per 1000 patients treated. I would suggest continuing with the drug, but be sure the doctor keeps a close watch for potential side effects. It would help if he could tell you what to look for.
I totally agree with Marsh. My husband's neurologist put him on Seroquel. She and I both know the drug is contraindicated for the elderly because of cardiac complications. She looked my straight in the face and said "you both need a life, don't you". That medication controlled the rages for another year at home. Very well worth the risk.
I just made an appt. with our neurologist after seeing my husband so agitated and upset that he couldn't stop pacing, talking, moving things, asking questions, etc. all evening long and sometimes during the day. His next appt wasn't for a couple of weeks and I won't last that long. I know that the neurologist isn't going to be crazy about medication, but it's either that or I won't make it. I don't think it's fair to my husband to be so anxious. He was saying that he was afraid, going to die, etc. I can't see him be like that. My fear is that he is not going to exhibit the behavior that I see when we're at the doctor's offce and I hope the dr. will understand how bad it is at home.
FLGIRL, if it were me call dr back and ask nurse to work you in sooner. say hes talking suicidal they WILL get you in..if dr is reluctant to medicate, you should try another dr. sometimes the 'risk' associated with the meds used for AD anxiety are worth it if you weigh out the pros/cons//we also took zyprexa for afew months and that is also got a black box warning as does seroquel and most all of them, the drs just dont have much choice with meds and alzheimers-many of us here have had to resort to using some sort of risky med for aggression and or anxiety to help our LO thru these difficult times. divvi
Oh, I did get an earlier appt---we're going tomorrow. I would have gone to someone else if they hadn't gotten us in right away, but they were very good. He's at it again...calling my name over and over, asking me if I love him, opening every drawer and door looking for the wallet he misplaced, says he's scared, etc. I am not looking forward to tonight since I see it's going to go on and on....
marsh, thanks for the information. i will find out from dr. what signs to look for. i so appreciate the responses from everyone. yesterday wasn't as good for dh as the past week. medication may have to be adjusted. dr. said it might have to be,he said we would just have to wait and see. FLgirl,all sounds so familiar. my husband would range through the house looking for his billfold,[which he has lost hundreds of times] or finding junk mail or anything to go through,opening every drawer and door in the house. he never said he was scared,he would just say "i can't stand this",or"i can't stand this anymore". i went through the same things with my dh,he can act so normal in front of other people sometimes and be laughing with the dr. sometimes being in a good mood [although he didn't do this the last time we went,he would hardly talk to the dr] and then after the app. he would be just in a terrible shape. drs. app's always upset him,because it brings home to him how bad he is getting. he is very good at hiding how he feels in front of others,at times,most of the time he just doesn't like to be around others. if you cant talk to the dr outside the examining room or write down how your husband is doing and give it to the dr.or have the nurse put it in his chart so the dr will see it,this could help. i am sure the dr will give your husband medication. i am supprised he hasn't already. bless your heart. my prayers are with you. good luck with your drs. app. bless you all .you all have been a lifesaver for me and i thank you so much. jav
The doctor's first suggestions was to "redirect" my husband from his various behaviors! When I started to cry, he realized that we were past the redirect stage. He said that many medications normally given for Alzheimer's Disease had side effects that were worse than the problem they were supposed to treat. So he gave us clonazepam, a very low dose, that he said would also help reduce the myoclic jerking. I gave my husband one pill tonight and it has had no noticeable effect--will try increasing it to 2 (dr said that was OK) and see if there is any effect. It's so hard to have him hanging over me whatever I'm doing asking the same questions over and over. He said there were men in the house smoking tonight!
FLgirl, what stage do you think your husband is in? sometimes medication takes awhile to take effect,it has to be in the system sometimes,days or weeks,before you can tell difference. i don't know about clonazepam. did your dr tell you how long he would need to take it before it would help? does your dh take medication to help with his delusions? medications effect people in different ways. a medication might work good for one person and another person might not be able to tolorate it. my husband has never seen anyone that wasn't actually there,i live in fear that day will come. bless you, i will pray for you. jav
He's in stage 6, I guess. He can take no part in dressing himself; it's like dressing a manequin. He has anxiety agitation, thinks people are in the house or coming to attack us, no focus on tv or conversation, doesn't always know who I am, can't be left alone for longer than a few minutes, not incontinent yet but accidents and always needs help to use the toilet, etc. He was only diagnosed 2 years ago; I never thought he would go down so fast. I'm hoping that the meds will start to kick in. It's only for the evening--not a long lasting med, but hopefully will help some of these sundowner symptoms. That's when he becomes so agitated.
How sad this is for you to see your hubby this way...I would suggest NEVER talk to Dr. in front of him or even with family or friend....when you go to Dr. write a note to them to read.saying you don't want to talk in front of him..Make it a fun time with it is time for Dr. visit.. promise you will take him out for lunch and a milk shake..any think he enjoys doing but never talk in front of him his condition..give him hugs and spend lots of qualified time with him even picture albums are nice...put music on dance with him, always make envionment fun and happy...JOY
Thanks, Joy. You affirmed what I was thinking...he got so upset about what I told the doctor that he's still perseverating on it! It's so easy to get wrapped up in the misery of everything that I need to remember that his time is limited and it should be as fun for him as possible.
The medication was a nightmare. The first night it didn't work and the second night it put him into a stupor laying on the floor most of the night. Even the next day he was really out of it. I don't think I'll use it unless the agitation is really too bad to handle. It's just so hard to do anything but follow him around the house picking up the pieces as he clumsily drops things, picks them up and puts them in strange places, etc. There just doesn't seem to be anything that makes this any better.
FLgirl, sometimes it takes time for a patient to adjust to a drug. Is this something you only give the patient once in a while, when the symptoms are bad, or is he supposed to be given a set dosage regularly? I'd talk to the doctor about what you've seen so far. Maybe the dosage needs to be adjusted, maybe you just need to give it time, maybe your husband would do better on something else...
Yes, we go back up to the neurologist next week. He said to give him 1 pill at about 5 pm since the worst agitation was happening in the evening. Then he said I could give him a second pill if the first didn't calm him down. The dr said it was a very mild amount so maybe it was something else that set him off. I don't want him to be a zombie since tomorrow is his birthday and I want to take him out to dinner. I couldn't have taken him the way he was Sat night. I know that dinners out will soon be a thing of the past, but I want to do it as long as it's possible. I really hate to cook every night!!