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 Coping with Violence: If Your Loved One Changes 
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Joined: Sat Oct 06, 2007 4:28 pm
Posts: 743
Location: LA
Post Medications
skyeskye, I'm going far "0ut on a limb" here in asking this question but after reading all of your posts, I cannot find the exact medicines your mom is on. I know that even in this day and time, many of the physicians are still treating our LBD loved ones the same as they treat the "run of the mill" dementia patients. That method usually comes back to haunt us. Please either list the names of the meds here for some of our knowledgeable members {Robin} to help guide in helping your mom find an answer or study the information at the beginning of LBDA. You will find the guidelines ready for you to study and if her meds are not along those lines, perhaps they are not the best for her. Please accept this concern as nothing more than wanting the best for your mom... If your doctors are following the Boeve Continuum then I have nothing more to add but it will bother me until I hear that is the medicine plan she is on.

Dorthea

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"See this lady she's 85 but she's nice" When I joined in 2007 this is the way Mr B. introduced me to the people only he knew,he added "You need to listen to her" he was 89 then, death due to Lewy Body Dementia/pneumonia in 2009.


Thu Aug 13, 2009 6:30 pm
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Joined: Tue Oct 16, 2007 11:27 pm
Posts: 84
Post 
The Adult Day center that John attends told me that he was a little agitated on Monday, but it passed. They know that I am looking into placement for him so they are working with me. Well, this morning he woke me up at 5:00 crying saying that his sister died and no one told him, after I talked to him and convinced him this was not so he went back to bed. When I picked him up tonight from the Adult Center they said he told them his sister had died, I explained the situation to them. But then they proceeded to tell me that he was very agiated today, he yelled at them when they wanted to help him change his pants, he accused them of taking his gun and he screamed for them to give them his F***** gun back, it has 9 bullets and he's going to shoot them he argued and told them to back off, then they got him to sit down and when I picked him up he was all smiles. Of course if this continues they won't keep him there, in talking to the director I told her that I don't know what to do. His doctors are in the VA system, they do not call back. She suggested that if he gets agitated over the weekend just take him to the VA ER and tell them his meds probably have to be adjusted that he is a danger to himself and to me. I have to get him stanbalized because any NH would give him the boot if he acts up like this. It just gets better and better. :cry:

B


Fri Aug 14, 2009 6:07 pm
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post 
There could be some sort of infection causing this sudden behavior, could be a UTI or a even a tooth giving him some problem, often when they get sick it effects their behavior. Good Luck!

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Irene Selak


Fri Aug 14, 2009 9:48 pm
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Joined: Wed Apr 01, 2009 9:44 pm
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Location: Minneapolis MN
Post Re: Medications
dorthea wrote:
skyeskye, I'm going far "0ut on a limb" here in asking this question .... Please either list the names of the meds here for some of our knowledgeable members {Robin} to help guide in helping your mom find an answer or study the information at the beginning of LBDA.

If your doctors are following the Boeve Continuum then I have nothing more to add but it will bother me until I hear that is the medicine plan she is on.

Dorthea



You're not out on a limb. I don't know current doses (forgot to ask the doctor the last time I talked to him) of everything, and Mom's meds have been continually tweaked over the last 5 months, but here are the basics:

Zoloft. I asked the doctor at the psych ward about Effexor and he agreed it was a good idea to go with a broader anti-depressant. He will take her off the Zoloft after giving Effexor time to kick in. Before Zoloft, it was Paxil, before that Celexa. Before that something else. Mom's been on anti depressants for a couple years. We started them when she got very depressed after my sister-in-law died unexpectedly.

Namenda. Don't know current dose. Mom's been on this a couple months now.

Aricept. Again, don't know dose, but she's been on this since last fall.

Zyprexa.

She was on Risperdal, but was taken off about 3 weeks ago. She was also on Adivan, but not now. And I'm not sure why.

The nurse at her memory care facility has suggested Seroquel, but the psychiatrists have not put Mom on this.

I know that the recommendations are to start with low doses, but it seems to be taking forever for meds to work (assuming that they will). And they get changed so often that I don't know how the MDs can decide if they are going to work. I did ask that the Effexor dose be upped - I'm on it myself, and 75mg is pretty low. The doc agreed to go higher, but I don't remember if it was 100 or 150.

They tried trazodone, but only at 25 mg, and it didn't do anything. I'm guessing that, for it to help Mom, she needs to have at least 75. I gave her 50mg the day she tried to walk away three times and it didn't slow her down a bit.

I'm not familiar with the Boeve Continuum, so I'll read up on it. Thanks for mentioning it.

skyeskye


Sat Aug 15, 2009 11:53 am
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Joined: Wed Apr 01, 2009 9:44 pm
Posts: 8
Location: Minneapolis MN
Post 
One more thing. Mom did have a UTI at one point. They caught it on her 2nd psych ward visit. I will pay more attention to some other things that may be bothering her. She has periodic problems with back pain, neck pain and restless leg, but when I've asked about those things, she's usually so focused on the wanting to go home that she denies there's anything wrong. I was surprised that she had a UTI and hadn't complained of symptoms.


Sat Aug 15, 2009 11:55 am
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Joined: Sat Oct 06, 2007 4:28 pm
Posts: 743
Location: LA
Post Medicines
Sk--
Most of our loved ones do not or cannot tell us what is bothering them. We need to be forever on the detective trail. Missing the UTI is fairly common. It can be treated. The restless legs syndrome is a problem I need to do battle with almost daily. Gabapentin seems to be the answer and I have added Advil although that is my own decision not doctor ordered and I do not see it recommended on this forum. Most of us here have had help with the seroquel. Seroquel is an antipsychotic which is fairly well tolerated by the LBD patients. My Mr B. could not rest at all without it. At night I put him to bed with the seroquel and melatonin [over the counter].

In case you have had trouble finding it:
Continuum - Dementia with Lewy Bodies, 2004
By Bradley F. Boeve, MD
http://www.lbda.org/feature/1347/diagno ... bodies.htm

Maybe Renata will chime in to help with the depression meds.

Hurridly, Dorthea

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"See this lady she's 85 but she's nice" When I joined in 2007 this is the way Mr B. introduced me to the people only he knew,he added "You need to listen to her" he was 89 then, death due to Lewy Body Dementia/pneumonia in 2009.


Sat Aug 15, 2009 1:18 pm
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Joined: Sat Jan 27, 2007 8:38 pm
Posts: 712
Location: CA
Post 
B --
Every VA clinic and medical center has at least one patient advocate -- usually their name and photo are posted right in the lobby. You need to call that person and tell them what is happening with respect to calls not getting returned, etc. Get the advocate's help in getting your husband admitted for a complete physical, psych and neurological evaluation. Let them know he poses a danger to himself, to you and to the day center folks. Let us know what happens.

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Renata (and Jerome-in-Heaven)


Sun Aug 16, 2009 3:27 pm
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Location: CA
Post 
skyeskye --
I'm just curious about the effect of being on both Zyprexa and an anti-depressant. At least one use for Zyprexa is to counter the manic phase in someone who is bipolar. Adding an antidepressant to that could make for a strange reaction, especially if the antidepressants keep getting changed. Has a psychiatrist done an evaluation or only a neurologist? May be time for a different category of specialist to get involved?

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Renata (and Jerome-in-Heaven)


Sun Aug 16, 2009 3:32 pm
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Location: LA
Post ...and knowing that,
MM, bide your time to erase unpleasant memories so the good ones will remain. I hope you can feel all of our arms around you.

Dorthea


Sun Aug 16, 2009 7:02 pm
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Location: LA
Post While starting seroquel
SK---
Quote:
The nurse at her memory care facility has suggested Seroquel, but the psychiatrists have not put Mom on this.


If or when your your mom is started on seroquel, remember to have them start low and go slow. She should be monitored closely. The reason I am writing this, it can be a blessing to you as it has been to many of us, however, Renata had a frightening experience when it was given to Jerome. You will be able to find out more about the condition to which I am referring by doing research on LBDA but for now I would point you to an entry by Renata as follows:

Quote:
raffcons

Joined: 27 Jan 2007
Posts: 625
Location: CA
Posted: Tue Jun 23, 2009 9:46 am Post subject:
Ditto on everyone else's advice. Jerome was one of those rare folks who had a very bad reaction to seroquel within a few hours of his first dose -- neuroleptic malignant syndrome (NMS) symptoms, including spiking blood pressure, fever, rigidity, pain, confused, unresponsive.

The prescribing doctor pooh-poohed my panic when I called him in the middle of the night, but I called his regular internist who understood the situation immediately and walked me through what needed to be done right then.

So, just keep an eye after he takes the seroquel and if you see some marked physical reactions to the drug, take appropriate steps.

Again, I want to emphasize that Jerome's reaction to the seroquel was rare.

Good luck!
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Renata (and Jerome)


Best of luck with getting your mom on a good path to help her.

Dorthea


Mon Aug 17, 2009 4:49 am
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Joined: Wed Apr 01, 2009 9:44 pm
Posts: 8
Location: Minneapolis MN
Post 
raffcons wrote:
skyeskye --
I'm just curious about the effect of being on both Zyprexa and an anti-depressant. At least one use for Zyprexa is to counter the manic phase in someone who is bipolar. Adding an antidepressant to that could make for a strange reaction, especially if the antidepressants keep getting changed. Has a psychiatrist done an evaluation or only a neurologist? May be time for a different category of specialist to get involved?


The anti depressant(s) and the Zyprexa have both been prescribed by psychiatrists.


Mon Aug 17, 2009 9:17 am
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Joined: Sat Sep 26, 2009 1:54 pm
Posts: 11
Location: In between Kentucky & Tennessee!
Post Mom had a violent episode...
and I hope it will be the last, but after reading your posts, I understand that it's probably not. She is on Risperidone two tabs twice daily (those little boogers are SMALL!!); Zoloft and a vitamin. She's been on the other stuff but we're loving the Risperidone because it has calmed her and she can sleep. But today, she "went off" on my niece. My niece was trimming her hair, a normal activity, when my mom asked her where "Joe" was...my niece said that he was in the garage, but my mom said, "He's probably out there with a new girlfriend" or something like that. My niece told her that papaw wouldn't do that and my mom picked up the tote with all her hair supplies in it and threw it...curlers, brushes, blow dryer..it all went everywhere. THEN, she head -butted my niece!! She smacked her and when my dad came up from the garage, he had to hold my mom down with all his might. He had to yell at her to calm down...he was so upset that he had to do that. While he was holding my mom down, she kicked at my niece (who was picking up all the stuff) and then tried to trip her. It was quite a scene. It was over as quickly as it started and she became overly compliant and sweet. She's been agitated and given dirty looks before, but never this. I must add...because I'm wondering if this has anything to do with the incident that happened yesterday. Her bathing nurse came and took her b/p...it was 58/38. They took it 3 times, took her to the hospital, had all the tests done, her b/p went to normal and then up to 186/??? All the tests-UTI, dehydration, and whatever else came back normal and the doctor couldn't give a reason for the b/p fluctuation. Do you all know? I'll post this elsewhere, but wanted to ask you all too.

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Nita


Fri Oct 23, 2009 8:29 pm
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Joined: Sat Jan 31, 2009 7:21 pm
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Location: Ohio
Post 
Nita: my DH had the same thing happen when he first went on risperdone in the hospital 2.5 years ago. All they did was give him a soda with caffeine & have him walk around & it went back up. After he came home on 3 mgms of risperdone we had the same thing happen about 3 months later & the geri-psych had me reduce the bedtime dose to 2 mgms which he's been on ever since. His BP is fine. Two weeks ago his risperdone was increased to 3 mgms for agitation & irritablility. I give him 1 mgm at 11 am & then 2 mgm at bedtime. It has to be given the same time everyday. His agitation has slowed down & hurray, he sleeps all nite. I have to wake him in the morning. (he fell the previous week at 3 am)Anyway, he remains irritable so the dr. reduced the zoloft to 100 mgms each day & as long as I'm very careful in what I say & how I say it he's fairly good altho' he can get really nasty. I hope this is helpful. Dee


Sat Oct 24, 2009 1:08 pm
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Joined: Tue Jan 05, 2010 5:27 pm
Posts: 146
Location: Fl.
Post 
Hello all,
Very bad weekend! My Mom hasn't hd a bad agrey violent behavior in so long. well this weekend was it. Saturday she was good most the day. she is in the state ofmind now that she really is not here reality wise. I am use to that. But that noight all of a sudden she thought the house was on fire. Told me I have to open the doors and let the smoke out and we have to get out before we get burned up, Now she can't really walk very well at all but she is trying to get out the front door. I did open the main door and left the screen door. It is in the 20's here. So having her walk out side was a NO. I got her to look around and showed her no more smoke it is all ok and talked her into lying down for a bit. It seems to help her moods swings. .....Well I guess it could go either way she wakes up sometimes totaly diffrent. Anyway she was better after she layed down a bit. By then I just had a baby abd she was the only one that could help me, I could deal with that better! :)
But that night she woke up angry as ever at me, then later she was good, Sunday she was ok, had a small hallucention time but slept most of the day didn't want to eat anything most all day, and then Sunday night she got up 7 times to go to the bathroom. Almost every hour.
Now I am starting to watch for these outbreaks of vilence. She does not take Seroquel, she is on Arecipt. 5mg.along with 3 other depression meds. I am going to call the Doc. today and let her know how she was this weekend. Can she take them both or does she have to get off Arecipt? (I know I spelled it wrong, just a little tired)
Thanks for listening, can use all the help I can get!
Tammy

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Mon Jan 11, 2010 8:52 am
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Joined: Sat Jan 03, 2009 2:59 pm
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Post 
Tammy,
She can take both Aricept and Seroquel. Some people can't take seroquel but many can with success, if the doctor agree's start at a low dosage to see how she will react also if this was a sudden hallucination out of the ordinary for her, keep an eye out for a possible infection!
Good Luck!

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Irene Selak


Mon Jan 11, 2010 11:11 am
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