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 New member from CA with questions about meds 
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Joined: Wed Jun 09, 2010 4:53 pm
Posts: 42
Location: Davis, CA
Post New member from CA with questions about meds
Hi everyone. This is a wonderful service provided by the association. My dad has LBD, although he has not been definitively diagnosed. He has all the characteristics, and we think he's had the disease at least about 4 years, although he's never slept well, and with every hospitalization has had strong visual hallucinations.

My parents live in Oregon and I'm here. I was out for about 2 weeks after a recent hospitalization for a fall. My brother and his wife, who live in Oregon, agreed to be the primary people to look after my folks when they moved to OR about 4 years ago. My dad is currently in a nursing home and my brother and his wife have agreed to take both my parents in when they are able to find a bigger home. They are angels, but I also worry about the caregiver stress they will face.

There are two medication questions I have. My dad is depressed. We sometimes find him weeping or he will begin to weep when talking about his past. Sometimes I think that this is just part of the dying process - he has regrets - but I also wonder if there are anti-depressants that work well with this disease? There's a lot of depression in my family.

Also, is there something he could safely take so that he gets REM sleep at night?

Thank you so much for any suggestions!

Peace


Tue Jun 15, 2010 5:30 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Hi Amanda,

As you may know, a definitive, confirmed diagnosis is only possible upon brain autopsy. I hope you'll discuss this with your father!

"manymoons" - one of our erstwhile members here - lives in Oregon. Her husband had LBD.

Where are you in CA? We have a Northern California LBD support group, if that is of interest.

There are some sedating antidepressants, which may help with both issues. Trazadone is a commonly used one. I encourage you to read Dr. Brad Boeve's 2004 "Continuum" paper on the treatment of various symptoms in LBD. He has a lot to say about both depression and sleep. You can find it by doing a search on lbda.org.

The weeping problem may be regrets about the past, as you say. Emotional incontinence (or emotional lability) is also very common in many neurodegenerative disorders. This could be what your father is experiencing.

Robin


Tue Jun 15, 2010 5:43 pm
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Joined: Wed Jun 09, 2010 4:53 pm
Posts: 42
Location: Davis, CA
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Robin, thanks for your quick reply. I live in Davis, so somewhat north. where and when is the support group held?

I will read the continuum paper and thanks for the tip on the medication!


Tue Jun 15, 2010 6:00 pm
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Joined: Wed Jun 09, 2010 4:53 pm
Posts: 42
Location: Davis, CA
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I have searched for the continuum paper on the association website with no luck. I found a more recent editorial by Boeve, but nothing for 2004. I have seen it mentioned in other posts. Can someone please point it out to me?

Thanks,

amanda


Tue Jun 15, 2010 6:22 pm
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Joined: Thu Jan 14, 2010 2:40 pm
Posts: 88
Location: California
Post Boeve Continnum
If you type "Boeve Continnum" into the LBDA Home search field, it should be the first article at the top of the page. This is the title of the article:
"Diagnostic Review & Medicine Management of Dementia with Lewy Bodies"
Best Regards,
Roxanne


Tue Jun 15, 2010 7:05 pm
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Antidepressants
Hi. On antidepressants, I also recommend the Boeve Continuum. On a personal note, I can also give you my experience with my Mom's trial and error on antidepressants. Over a year's period, she tried 1/2 tab prozac daily in AM - had GI problems and we quit, she tried Citalopram (Celexia) - dizziness and increased hallucinations and we quit, and finally sertraline (zoloft) at 25 mg in the AM and 12.5 mg in the PM. It has taken a long time to try various antidepressants and to find the right dosage. We think we have found it with the sertraline.

However, it has been worth it. At this point I think that the sertraline has stabilized her mood most of the time and with her other crucial medications (exelon and desmopressin) helped her to work toward accepting her condition. She still has a "brain storm" (what we call her temper tantrums) once every three weeks or so, but generally she is interested in her surroundings and better socialized with everyone in her ALF. Start low and go slow. We tried too much setraline at first and experienced cognitive difficulties and diarrhea...had to cut back. Often we go too far, then decrease dosage to find the right amount.

I do think an antidepressant can help to make things easier for you and for your LO. Good luck to you. Annie


Tue Jun 15, 2010 10:52 pm
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Joined: Wed Jun 09, 2010 4:53 pm
Posts: 42
Location: Davis, CA
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Thank you all so much for your replies and support. My dad is 91. It's hard to say how long he's had this, really, but there's is no doubt after his last fall. My parents hid a lot of his condition from us, but my mother has been revealing more and more lately. Of course, I could tell he was terribly physically diminished and more and more "not there," but we had no idea, really. Right now the nursing home has him on ambien for sleep. I wonder if anyone knows whether this is an okay drug for LBD victims? My dad has always been very vulnerable to meds, especially opiates, although I know ambien is different.

I'm also curious as to whether any research has been conducted on underlying mental illnesses that may make one more vulnerable to LBD. I'm thinking about major depression or possibly bi-polar 2?


Wed Jun 16, 2010 12:03 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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There is research that indicates that mid-life depression is highly associated with late-life dementia. I don't know if any LBD-specific research in this regard.

In the "LBD Research" area of the forum, there is probably one or two articles on how depression can occur a decade or more before someone gets LBD.


Wed Jun 16, 2010 12:32 am
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Searching
Hi Amanda. On ambien, I think that if you do a search through this forum you'll find lots of discussion about both ambien and sleeping medications in general. I think the search function is a great help on this website. To use it, go to the menus at the top of this forum, click on search, and enter a key word or two. I tried "ambien". The most recent posts come up first in the list.


Wed Jun 16, 2010 7:56 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3113
Location: Vermont
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Hi Amanda - welcome to the forum, and sorry you have to be here. But there is wonderful information and wonderful people here to help.
My dad has been on Sertraline for almost a year. LBD was suspected this time last year, but now they are saying probably some other form of dementia. So, just be careful of meds and like everyone has said, start slowly and cautiously. It's hard to know what type of dementia people really do have. We've had lots of guesses!
The LBD chat is another good place to communicate with CGs and other people with some connection with LBD. Hopefully there will be someone on there if you want to chat.
Take care, glad you found this forum. Lynn


Wed Jun 16, 2010 1:47 pm
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
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Hi Amanda,
Welcome to the LBDA forums, I am sorry for your need to find us but glad you did.

As to your question for medications for depression, in my own case we used Trazadone with great success!

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Irene Selak


Thu Jun 17, 2010 1:39 pm
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