I gently beg to differ-maybe not so gently. First of all in this country facilities must attempt to titrate med dosage down regularly. It is illegal to chemically restrain a patient. Seroquel and the like do indeed carry a black box warning about use in the elderly dementia patient. What-pray tell-do you do with a violent, young, and exit seeking resident. I had to hire a private aide in addition to paying privately for my husband's dementia facility. After a bit they warned he could not stay there. Two alternatives-warehouse him in a terrible place too far away for me to oversee his care or put him on an anti psychotic drug. My my-I was so upset I couldn't spell right :-}. Quality of life is more important than quantity.
I think it's a poorly written article. Yes, anti-psychotics are prescribed to control agitated behaviors in dementia patients, however, the article doesn't give an alternative except not prescribe them! I'd like to see the investigators who came up with those findings live with my husband (and take away his meds). I think they would change their minds pronto.
Also, the side effect that is given is higher cholesterol counts and weight gain. To be frank--dementia is terminal--who cares about higher cholesterol and weight gain in a dying patient? Ultimately, I believe most lose a lot of weight when the disease progresses and their bodies can't process food properly. The side effect my hb's neuro mentioned was a slightly shorter lifespan due to increased risk of stroke; I think it's a worthwhile tradeoff. There was absolutely no quality of life for my husband when he wasn't on the right medications--he was upset and angry much of the time. Now, with the correct psych meds, he is content and cooperative, but not "zonked out".
The link to the article is - http://www.huffingtonpost.com/2011/12/01/elderly-dementia-antipsychotic-drugs_n_1123195.html
I completely agree with Bluedaze* and MarilyninMD. Let the "experts" try to deal with an out of control, raging, fighting, escaping, hallucinating dementia patient. The anti-psychotic meds. allow them to have a calmer life. And sorry to be so blunt, but so what if the meds. cause a stroke or a heart attack? It saves them the horror of lingering in end-stage Alzheimer's Disease for an undetermined amount of years.
Hi all...I just posted the article fyi In no way am I judging anyone who has their spouse on any drug. if my husband becomes delusional or violent I will surely do what I have to to be able to care for him. It is good to be aware of the possibility of being drugged into submission though. This is not a new issue just new drugs ...As a young one my first job to save money for college was working in a nursing home which I did for six years. This was a county home near Chicago and believe me there were good and bad nurses, good and bad drs. etc all the intrigue of "General Hospital" but the bottom line is there were residents that were sometimes over-medicated to the point where they would have painful spasms....so the more knowledge we have the better.
My hb is a walker; consequently, I have keyed deadbolts on all outside doors. He also "investigates" and moves, hides, whatever he's interested in at the moment. He was placed in the special unit of the local care center in October after a hospital visit for fall in our house knocked him out. His behaviors continued there, stubborn ole guy that he is. He was given resperdone. He would sit in chair, head down, drooling and not be able to eat or do anything. I asked the doctor to change or lower meds so he was at least able to eat and function a bit more normally. He did lower the dosage of resperdone. Monday, hb became unresponsive with bp in 50s/40s. In the past couple of days, all meds withheld, nurses say, he's become "himself"--as he was previously. Still in hospital, hasn't walked, but eats, holds head up, talks altho' as usual most doesn't make sense. Probably be discharged today. I'm wondering if the resperdone was a possible cause of bp drop. No other cause is apparent. Such a fine line to walk. I don't want him to just sit and drool before "his time," but as folks say, dementia is terminal.....
Zibby, I am not a medical professional but I do believe the symptoms your DH exhibited are a result of the Risperdal. My DH was prescribed the lowest dose of Risperdal by a world reknown geriatric psychiatrist....the first dose renedered him unable to communicate, unable to walk without assistance, caused tremors in his extremities-in a word made him a zombie. I insisted that the drs take him off the drug IMMEDIATELY. He was himself a day later. Yes, I think it was the effects of the Risperdal.
Thanks for prayer, Mary75 and thank you for affirmation that my hunch that Resperdone/risperdal might be a cause of "zombieism," LFL. This afternoon when I visited the hospital I talked w/nurse. She said hb will be returning to care center tomorrow. He's been getting hydration and antibiotics since he's been there. She said in reading the doctor's notes, he thinks the incident might have been the beginning of sepsis. Anyway, hb is doing okay.
Risperdal wired my DH that he didn't sleep for two days.Just kept pacing and rearranging things all night.I was exhausted just keeping track of him and the things he kept moving . I did just start him on Melatonin at night and is helping tremendously,hope it keeps on, I need some sleep.
Risperdal didn't suit my DH either, he was always in such a rage , he was going to self harm with a big kitchen knife, I rang his Dr and he said take him off it now. I was going to try him on Seroquel, but decided to see how he goes not on any meds...so far so good. He's still very confused, paranoid, and halluncinating quite a bit, but I think he would still be anyway, as that's all part of AD. He sleeps well, and does get up during the night to toilet himslef, that I am very grateful for..
I just read a study of psychotic drugs in dementia. Haldol was the worst, causing twice the deaths of the others. Seroquel was the best. The others were sort of in the middle. Based on this, I would try Seroquel first, then, if that doesn't work, one of the others, but Haldol only as an absolutely last resort.
marsh-I totally agree with you. When my husband was on a psych unit the first drug they wanted to use was haldol. As you know it is an old drug that is cheap and has always worked. Much newer meds are now available. When I refused haldol for my husband they threatened to discharge him because I was "refusing treatment". Felt like I was still in the dark ages-or they were.
i also tried less than 1mg of haldol for DH a couple months ago per hospice dr. he drooled over himself and slept for 15hrs. it took a second 24hr period to rid the drug from his system and he was back to his norm. we just never know.
I can't even imagine going through this without Geodon, the antipsychotic drug that has worked for my DH. Without it he sees "bad guys" and is manic and agitated. He is much more comfortable on this medication.
Zibby, my husband also fell almost a year ago early in the morning in our bedroom. I got up immediately and found him in the fetal position twitching and jerking with his eyes rolled back. The trip to the ER put him into respiratory arrest and landed him in intensive care. He was never the same. So I learned about how sedatives and anesthesias affect him the hard way...and at his expense. I've been through the zombie, head hanging, drooling, slack jawed times. Any time he is given new meds that do that to him, I immediately stop them. I figure those drugs go straight to his brain and his brain is damaged and not functioning normally anyhow. I also have keyed deadbolts. Lloyd is a walker/investigator/mover/hider, too! Hang in there, girlie and follow your instincts. No one knows what is better for him than you!!!