Does anyone know anything about this drug....or had spouse on it. The Mental Health have assessed DH and want to try this drug It seems Respiridone .5 x 3 day is some improvment but not enough...they say he's still very aggressive verbally and physically, and impulsivity with ongoing threats..
Julia--Several years ago, my husband was in a clinical trial using this drug for AD. He clearly didn't get the placebo, because it caused significant digestive issues and was taken off it after one week. I believe the results of the study were negative; however, perhaps there have been others where positive results were obtained. You could ask the doctor about that.
There are many other anti psychotic drugs besides risperidone--I'm curious--why didn't they suggest any of those? As I understand it, sodium valproate is actually an epilepsy drug.
"CONCLUSION: Low dose sodium valproate may be effective reducing a broad range of types of disturbed behaviours in aggressive demented patients".
This was the finding of an NIH study in 2004. While there is not strong evidence that it works for all patients many in the study were clearly better after taking the drug. Hope this helps.
Julia, it is sold as Epilim here and is used in the treatment of epilepsy. My sister (52) has been taking it for trigeminal & occipital neuralgia, for a long time, without any side effects. It was the only one of similar types of drugs that she could tolerate.
MarilynMD..I checked it online, and yes that's one of the side effects, they are starting him on 100mg for 5 days then if tolerated up to 2oomg for 2 weeks then a blood test to check the levels. They said they treated another patient there with this drug and it helped him...I don't know what to think.
scs...I hope it works, because, I'm not happy with how Dh is looking right now...they are stopping the EXTRA Respiredone as needed and Temazepan.. When I go to see him, he just wants to sleep all day, and dribbling...yet they say when they're there, he's ok, very fiesty and aggressive.
Cassie, yes i saw online that it's for epilesy...that's why i didn't understand why they are giving it to him at first... I tell you...I'm so close to bringing him home...if I had him so medicated, I possibly could have kept him home...all this in just 7 weeks of being in the N/H
Julia, if you husband was jerking or having spasms that drug may be suitable but for aggression? Doesn't sound right. Can you take your DH to his previous doctor? (And bypass the nursing home dr). In NSW that is permissible. My DH took temazepan as a sleeping pill but only a very small dose. Hope that you can work it all out soon
Cassie, when he went into care, they expressed strongly that it would be easier for their GP to see him while he's there seeing others..I think perhaps easier for them. I am going to try and see if i can talk to his Geriatrian at the local hospital today.
I just feek like i have no control anymore, they just do what they do...it's like they all stick together, it's hard to get much information from them. Thanks so much.
That sounds like a very good idea, about speaking to the geriatrician. (Or anyone else that you can find.) Nursing homes in general do not know how to deal with dementia patients (unless specifically for dementia.) My DH wasn't in one but both his parents were and I was their advocate. At one stage MIL (who had ftd) was not behaving well and the DON called me in to, "speak to her about her behaviour" and to let her know that if it continued she would have to leave! And from my overnight hospital stays with my DH it was very apparent that patients were expected to be asleep all night! I found the nursing staff in both places to be sadly lacking in knowledge and compassion. So, it is all up to you but from where I am sitting you are doing a great job Julia, for your DH, so keep it up (if you can!)
Thanks for the encouagement Cassie...I'll do my best. I just want him to be comfortable without being doped up to the eyeballs.. The staff there just do their job, they say they have to keep everyone safe....there are 16 patients with just 3 carers for them in this particular secure ward..they call it "house". Next Monday we have a family conferance with the DON / manager there, my Dd is coming with me for support and she'll ask lots of questions...I'm am making a list.
Julia my antenna are telling me that the patient to staff ratio is pretty low and they may resort to keep folks drugged to "keep them safe". Please push on and ask the questions to make sure your DH is getting the care he needs. Also great idea about talking to his previous doc re meds and you can even request he sees your husband to review his chart and meds. Keep up the good work.
Julia, just to let you know, several dementia patients with agitation/aggression are on meds frequently used for controling seizures. DH is on neurontin and was on depakote until his liver enzymes were too high. Both of those meds are used for eplilepsy or seizures.
LFL...I thought it strange, but they say it might help him. He's to start with 100mg( bd) , whater ever that means for 5 days then if he tolerates it 200mg bd ...they are going to do blood tests after 2 weeks
I'm still waiting ti hear back from his geriatrician.
Julia, what reason are they giving for prescribing the drug? Aggression, agitation? In one of the posts above you were concerned about your DH being half asleep and drooling when you visited so when is he causing a problem for the staff? Perhaps you can vary the time of day that you do visit, to give you a better idea of what is really happening.Hope that I haven't said too much, don't want to cause you further worry.
Cassie, it's for aggression. When i go there he's very sleepy and drooling, even at 10-11 am, and when I've been there after lunch the same, he would have just had another respiredone then. I'm a bit worried about how much extra he was given in between doses as that was the Dr's orders, but to stop that now that he'll be on the new drug...gosh could he have been so bad. I'll see how he is today
Much better today...I took him out to lunch, then visited a friend for coffee. Not as sleepy, but still drooling. The Sodium Valproate 100mg was started yesterday, so lets see if that makes a difference. I shall be keeping a close eye in him....they assured me that it has helped other patients. I still want to know when and what sets him off...
So glad to hear that things are better today,Julia Your last sentence shows clearly that you are on the ball, hope that you can find what does trigger the aggression. (Oh, to be a fly on the wall.) Could be something as simple as personal space being invaded, especially if you DH is a very modest man. By the way, bd means twice a day.
Julia, my DH is home and honestly I can never figure out what causes the aggression. I feel like a failure because everyone says there's a trigger and the caregiver should be able to identify the triggers. I have written down when he has an aggressive episode and all the environmental/emotional factors and honestly I can't find a pattern or trigger.
I know from our experience that the lowest dose of Risperdal made DH a zombie and insisted that he be taken off immediately. They put him on Seroquel and increased it gradually and added the depakote first (bad liver enzymes) and replaced it with the neuorontin. DH has been on basically the same med regimen for 4 years with increases in the seroquel and addition of ativan this past month. His new geripsych took him off of the midday neurontin (100mgs) for a month and then added back in since it was the most effective med for controlling his midday agitation.
Oh, DH is on 100mgs of neurontin 3X day.
Good luck...perhaps the risperdal is creating the drooling.
Cassie, Dh is always on the defensive, goes way back to his childhood abuse, he puts up a barrier, doesn't trust anyone.That could be coming back as he regesses. Oh yes to be a fly on the wall, and see what really goes on there when we are not around. Thanks for the BD info.
We sat down at a table while waiting for the carer to give me his midday med to take with me. Well, one other gentleman got very upset, because we were at his table, and he doesn't like change, he went on and on about not being right, we should not change things, everything has to be just so...so we had to move.
LFL...yes, it's so hard to workout what triggers them off. With Dh, he used to think his stuff was getting touched or taken, hid everything, I still can't find a wallet with all his cards and quite a bit of money that he hid nearly a year ago.
I really do think it's the respiredal thats making him drool cause it's only been since they upped the doseage. I have to wait now to get the offical report from the mental health people and see how our meeting with the DON/manger of the N/H goes on Monday. His geriatricain only works on certain days at the hospital so, I'm still waiting to hear from her too...could be next week now....this waiting drives me mad, in the meantime I have to see him like this.
I'm wondering if Sodium Valprate takes a while to kick in... He's off the extra respiredal (more when necessary)...and started the Sodium Valproate last Tuesday. I noticed yesterday while visiting Dh, that he is starting to get agressive again...lost it just cause he couldn't get his reading glasses the their case with two paper napkins. I also noticed that he had a snarly look on his face, never seen him look like that before.. Can't wait for Monday, we have our meeting with the DON / manager of the N/H at 11.30 am...
Maybe because it is only a low starting dose, it will take longer to kick in? ( My sister takes 3 x 500mgs a day, for neuralgia) I have come across quite a few reputable news articles that are extolling the use of sodium valproate in dementia patients (for aggression & agitation)) so the nursing home is on the right track after all. Hope that you will see some good results soon, Julia. And good luck for tomorrows' meeting. Let them know that you will be watching at all times.
Thanks Cassie...yes I Googled it and found lots of info on it. My DD Linda will make sure they know we are watching them...she's daddy's girl, and has his best interest at heart. I'll post on how we get on..
Well we had the family meeting with the manager / DON of the N/H. DD and I were very happy with the meeting...we were able to put forward our concerns, mainly the meds DH is on...I am at last happy that they think they have him pretty much leveled out now with the Sodium Valproate that he has been on for just on a week now....still dribbling, but no more extra Respiredal. They have a new Clinical Care Nurse and she is a great believer of distraction rather than more meds, she is going to approach and train the carers to go that way in handling situations ...at last we are getting somewhere. I made it clear that I wanted to be kept informed of any changes , and the they needed to read the patients background history, which no one ever bothered to do...then they would have understood what would have triggered off his agressision Also, the carers and staff changed nearly everyday, they realize now that was not a good thing, the patients didn't get to build up a trust with them, so now they will work with the same patients for 4-6 weeks at a time, getting to know each one and more able to access their needs. Phew...I hope he settles better and his carers get to know what sets him off. Cassie who was that person that said "Life wasn't mean't to be easy," but this is sure the hardest thing I've ever had to do in my life...
Julia, I hope that you are feeling as pleased with yourself as I am, on your behalf ! And to think that they have even taken on board what you said about not changing the staff daily,it makes so much sense. The constant change is not what your DH or any of the others need. And the staff certainly should have knowledge of a patients' history ( even if it is only verbal) and they should relate to the patient accordingly. You certainly managed to get across to the don, all that needed to be addressed, well done!! And here's hoping that it will get easier for your DH and all your family, from this day forward.
Cassie, I'm much happier now, that all the things that concerned us have been addressed and hopfully will be taken care of....and at the same time it might also help the other patients.. Thank you for all your encouragment... We'll be watching how it all goes...