I'm new at this and probably this topic has been discussed many times so forgive me. My dh is taking Galantamine (8mgs) twice daily. He began with 4 mgs for about 4 months then the doctor increased to 8 mgs. He was dz 1 1/2 years ago with vascular dementia. It seems to me that after the 8 mgs. increase he has lost his appetite and is depressed. He spends his days in his recliner dozing and complains when I tell him it is time to eat so he can take his pills. He recently had a physical at the veterans clinic and he has lost 20 lbs since last visit about 6 months ago. The doctor prescribed something she thinks will increase his appetite the meds are mailed so he hasn't started that yet. DH asked last night if I think he is depressed - his personality has changed so much in the past couple of years I really couldn't answer that. He is just so different, he seems to not have an interest in anything that he did before this all began. So my question is does anyone's spouse take Galantamine and have these symptoms. Today is Thanksgiving and he said he just wished he was hungry and didn't dread eating. Not like him at all in the past.
Flo39...when a person has dementia...it is so difficult to determine the cause of some of its symptoms. Loss of appetite, depression, sleepiness, weight loss...could all be due to meds, but they could also be due to the dementia. I hope the appetite will increase with the new med prescribed....If not, maybe the doctor would want to try something other than galantamine; possibly Namenda, Exelon patch. Has your DH had blood work recently? It's possible something else may be contributing to these symptoms also. Good luck...this is so difficult. My DH was started on Namenda and galantamine when he was first diagnosed, then was taken off the galantamine when he started the Exelon patch. His neurologist said it may improve his mood and make him calmer; but not sure if the galantamine was causing any of the above effects or not. This was about 3 yrs ago...he still takes Namenda and Exelon...but he does have loss of appetite, wt loss and sleepiness; so who knows? He is usually fairly calm and cooperative, and seems happy most of the time. All we can do is try and hope for the best with this illness.
My dh takes 24 mg once a day and has for probably 4 or 5 years. It doesn't seem to have any adverse affect on him. I really don't know if it does any good any more because he is slowly sliding down hill.
How old is your husband? Like it was noted above...these conditions are so difficult and can be different for everyone.
My husband takes 16mg galantamine in the morning. He does have loss of appetite which can be a side effect but has not lost weight but gained and does eat when it is ready. But then, it might be he forgets to eat more than loss of appetite. He has been on that dosage for 3 years now. We did try Namenda but as shared before - too many bad side effects. He has to be moderate for Namenda under VA guidelines, since has FDA approval for moderate the severe AD. Since he has VaD I don't know how that would work. I will say after my sister's stroke almost 2 years ago, and I believe she has VaD now, she has no appetite, lays in bed most of the day sleeping or watching TV and is depressed. Of course - her kids don't believe there is a problem!
I've taken Dh off Aricept and Resperdal as they were making him more angry and agitated...he was going to take a knife to himself, it was that bad...Dr has given me Seroquel to try, but since stopping meds he is much calmer and easier to live with. I think I'll just see how he is with no meds for now..it's all trial and error, to see what works..
My dh was on Aricept for about 6 months and Namenda for only a little while. The Aricept originally had a calming effect on him, BUT, caused him terrible gastro-intestinal problems which I couldn't live with. By then, the calming effect had disappeared, as well. The Namenda was an immediate disaster for him - he flew into rages and was a bit scary, so I jettisoned that drug, as well. Now, he's on 40 mg/day of Celexa and that's all. I give him 2 Immodiums/day to control bowel incontinence and all has been well for a month now. I do have to be careful not to take him anywhere within a couple hours of his eating because I don't trust that he won't have a major blowout again.
He has begun sleeping A LOT lately, most days he won't get out of bed until 10 or so in the morning. I don't mind because that gives me time alone to accomplish whatever I want to before he gets up and needs to be fed, etc. I wonder if this excessive sleeping is the disease?
mothert: The sleeping has several threads that you might want to check. For three months my dh was sleeping approx. 18 hours a day. Usually slept 13 to 14 hours from bedtime to morning. Took a nap every day between 3 to 5 hours. Sometimes slept longer in the morning and took longer naps. He is now sleeping approx. 15 hours a day. I think it is the condition and also maybe a combination of the drugs.
At first it was frightening to me. I almost was afraid to go in the bedroom to see what was wrong because I was afraid he had died. Now, it doesn't bother me.
My hb has been in the "special unit" of the local care center since he fell and hit his head knocking himself out on Sept. 23. He was in hospital for 4 days while they evaluated him; then was moved to "special unit" for physical and occupational therapies with which he did not cooperate well. Today I noticed he's more wobbly when walking and put his head on the table for a nap while I was visiting him. I've had a couple calls telling me he's gone into other people's rooms and staff had difficulty "redirecting" (I love that word) him. Also, has picked up someone else's coffee cup on a couple occasions causing some arguing. Did that at home. Has urinated in "inappropriate" places. Did that at home, too.
Anyway, the director of the care center phoned me this evening to give me a heads up that they are sending his med and behavior records to a geripsych doctor for evaluation to see if meds should be adjusted. When he went into the hospital, he was only taking lisinopril for high bp. Respidrel (sp?) has been added. If the adjustment is better done in the psych hospital, he'll be moved there. It's 90 minutes away. AND I'm to start a 2-wk job as substitute receptionist Monday. Stress, you are NOT my bff.
DH has been off his meds since Tuesday, and It's amazing how much calmer he is, even family have noticed a big difference. Today he had to sign a car transfer form, he just could not grasp the idea that he had to sign, not print his name. After 5 tries I ended up signing for him....even after all this he still stayed calm. So some meds are good for some and some are not...every Al patient is different. I think at last with this new calmness, I'm starting to feel acceptance and compassion for my LO ..I'm feeling calmer myself. Just hope he stays this way.
My DH was diagnosed in 2006 with EOAD at age 50. He was given that title under dementia by SSD after he was tested by their people. His Doctors (GP & Psychiatrist who are local) just keep him under the general term of dementia because he doesn't want to go through any more testing. They work together and treat the symptoms.
2007 Tom started aricept... with noticeable cognitive improvement.... I lived here at the Alz. Spouse site and the Alz.org one....... I weighed out our situation and advice and thought I was doing the best of the best for him....
We went through the nightmares and not sleeping at night to me doing EVERYTHING and him acting live a 3 year old temper tantrum throwing child to leaving the house long enough for it to be safe to come back to risperidone to calm the rages to adding seroquel to help him sleep at night and calm the delusional thinking to having him sit at the kitchen table and drool.
That brings us up to Sept. 3011........
Tom got up one morning and said that's it!!!!! He was going off all his Alz. drugs. I let his Drs. know and I did it slowly......Now that was fun..... NOT!
He finally hit a plateau the first of November and agreed he DID need something but refused to take anything he had taken before. He WAS taking Zoloft, Aricept, Risperidone and seroquel. AND they all added noticible improvement for his symptoms.
I still slipped Risperidone in his coffee now and than till he started celexa when I seen that mean stranger in his eyes ... Then he would become this sweet person I use to know.... Others seen it too. Night & day.
His Drs. put him on celexa 20mg........ which has only been since the 17th of this month..... He and I are both seeing positive results..... "But is sleeping more."
The question is ... Was it the aricept that took us down this path?????
He told everybody I nearly killed him.....that he would be in a nursing home by now had he stayed on the drugs.....He's not mad at me.... he knows I am just doing the best I know how and he loves me for that.
He still has dementia and he acknowledges that and MOST of his losses but is now living once again to the best of his abilities and limits.
HOW do we know when a symptom is drug induced? I'm having a hard time getting past the guilt I feel...... I Hate this disease!!!!
Psych doctor evaluated reports the care center sent him last night and determined he's not a candidate for the psych hospital. Doctor will work with him here. Hb isn't violent; difficult to redirect and stubborn. Today they've assigned an aide to work with and watch him.
Thank you so much to everyone who took the time to post on this. I'm wondering if our pcp that we have here is the one to prescribe psych drugs. He is an excellent internist but I don't know just how up on dementia drugs he is. The VA doctor suggested two other drugs but I'm not going that route since he will only see a doctor there twice a year and since this is A.F. base it may well not be the same doctor next time. So I will just go with what he is taking now. He has so many meds for heart and other ails that giving another one hasn't bothered him. He does question the colors tho. It is sad to see this man who he is now line up the pills by color and size before he will take them. It could be amusing, I guess if it didn't hurt so much to see what this %*&#@ disease has taken from him.
flo 39--in my experience, the best doctor to prescribe psych drugs for a dementia patient is a neuropsychiatrist. It is a tricky business, there is always some trial and error involved, and it seems to me that it's beyond the expertise of most internists. It's simply not their area of expertise. If you live in an area where a neuro is available, you may want to consider switching. Dementia symptoms/behaviors can be so difficult to manage, I think you need the most qualified doctors on your team helping you.
many regular pcp wont prescribe the psych meds as they need to be monitored frequently and the risk of them not working but making things worse AND or/ the CYA theory of black box warnings . i agree with marilyn in our experience a qualified neuro/psychiatrist or geriatric specialist is a better choice and have more input on how the drugs should work and what to look for if they dont and how best to tweek them if changes are needed. at least until you find the right combo that works then maybe a pcp would just rx them. divvi
I wish there was some good way to know when the meds being used are no longer working without the risk of harming our LO...I know the Exelon is to help delay the loss of memory and the Namenda is to delay the death of brain cells but how do we know when they aren't working and what will the set back be if we do stop those costly meds? Will there be more harm than good? My DH is losing more memory and I am repeating more and more answers. It drives me batty sometimes. And now I look in the mirror and don't recognize who is looking back at me anymore, this disease has taken it's toll on me too in that dept..He on the other hand looks rested and perky most of the time.
My husband goes to the VA too and he gets his psych drugs and his dementia drugs from his geriatric psychiatrist. We always see her, so she knows him and sees my husband's progression with his FTD. We see her at least twice a year but I can make appointments to see her if something changes and I have her direct office number and her email. She has been extremely helpful.
Mimi - a very good question. For one place I suggest go back and read Dr Josh's reply to the drugs. There is so much unknown and as we all know - each of our spouses react differently. Yes, there are general behaviors and declines that we know will come, but for the extreme ones - the violent, hallucinating (dangerous ones), etc - some are affected, others are not.
Are the drugs working? will it hurt to stop? From all I understand you never know until you stop if they are working. Will it harm them? I don't think in the whole realm but if the drugs are helping, stopping will just bring them to where they would have been without them.
We all are tired of the repeating but many that are past it, their spouse is now silent, would welcome the repeating back. The repeating things and him repeating things to me, often within minutes of each other, drives me batty too. Most of the times I just say 'yes' and let it go. When it comes to asking about doing something or about someone I often loose it. Example: for a while my DIL talked of moving back in with my sister so she could have her surgery but it would never work out due to my sister's personality changes after her stroke. Well, my hb thinks she is living at my sister's. I keep correcting him, that it was only a consideration but he can't get past it. When he keeps talking like she lives there is when I loose it. I am hoping to go see the grandkids during Christmas and maybe being in their apartment will make a new 'memory'.
I guess we were very lucky with the psych drugs that his neuro put him on when he was raging and kind of psyco. He was on them for maybe 6 months or less and then he seemed to be so calm I suggested to his neuro that I try taking him off the drugs. He agreed and told me to just do it slowly. He was on two drugs. I slowly decreased the drugs and then eliminated one of the doses at a time. It worked great...he still remained calm and hasn't had to be put back on the drugs.