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 medications 
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Joined: Wed May 06, 2009 10:15 pm
Posts: 15
Location: Kansas
Post medications
My husband is experiencing agressive behavior, i.e., hitting me, kicking, verbal tirades/assaults. His doctor prescribed Risperodone 0.25MG. I'm apprehensive about giving him this medication. Is there an alternative medication with less risk to LBD patients? Is Risperodone dangerous for persons diagnosed with LBD?

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P. Jo Ann, 59, married 31 years to Richard, 78 yrs old. Richard was diagnosed spring 2008 with LBD.


Thu Dec 29, 2011 1:18 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: medications
Risperdal [risperidone] was very dangerous for my husband when he was put on it in 2008. He developed neuroleptic malignant syndrome. Fortunately, I ran across some British research articles that warned of this and discontinued it immediately. Fortunately, he returned to baseline. He had also behavioral symptoms that you described. Later on he was prescribed Seroquel which worked quite well. It was necessary to begin with a very low dose. He now takes 50mg twice a day. He still has occasional violent outbursts but the Seroquel has made a big difference. There are those who cannot take it but his neurologist says it is better tolerated than other neuroleptics.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Dec 29, 2011 1:27 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: medications
Most LBD experts prefer Seroquel or Clozaril, as their anti-dopaminergic side effects are thought to be less than the other atypical antipsychotics. Some do just fine on Risperdal. Others do not. On the other hand, some do very poorly on Seroquel or Clozaril. It's sort of a crap shoot. I don't see that you have much choice -- perhaps the alternative to treating your husband pharmacologically is placing him in a care facility. (You may have to place him in a care facility anyway.) The rule of thumb is start with a low dose, increase the dose very slowly, and watch very closely for side effects.

I suggest reading Dr. Brad Boeve's 2004 "Continuum" paper. You can find it by searching on lbda.org with those key words. He's an LBD expert who reviews symptoms and treatment regimen.

Further, I suggest you work with medical professionals and your family to ensure that you are safe around your husband. Do you carry a cell phone with you at all times in case you need to lock yourself in a room and make an emergency call to 911? Have all weapons been removed from the home?


Thu Dec 29, 2011 1:54 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: medications
I found this article very helpful: http://www.uiowa.edu/~centrage/archive/pubs/Newest%20Versions%20-%20pdf%20format/Coping%20with%20Violence.pdf. It's called Coping with Violence: When Your Loved One Changes

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Dec 29, 2011 11:02 am
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: medications
Thank you for that article, Pat! Good stuff -- and good to read well in advance of any need.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Thu Dec 29, 2011 7:40 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: medications
JeanneG wrote:
Thank you for that article, Pat! Good stuff -- and good to read well in advance of any need.

Jeanne, I pray you will never need it. With my husband, these were issues that emerged very early in his illness--before we knew it was an illness but that something was very different and terribly wrong. It would seem that the parts of the brain affected by LBD dictate the behavioral manifestations sometimes associated with it. Even so, 'forewarned is forearmed'.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Dec 29, 2011 8:46 pm
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Joined: Wed May 06, 2009 10:15 pm
Posts: 15
Location: Kansas
Post Re: medications
I wanted to give all of you a follow-up on my medication & agressive behavior post. I did speak to my husband's doctor about the concerns I had in using Risperidone. I requested Seroquel instead. I read the articles recommended by Pat and Robin. I copied some of the information and took it to the doctor.
I am giving serious consideration to Robin's comment about placement in a nursing facility. I did remove everything I could fathom being a weapon. I am going to carry my cell phone on my person from now on. My husband has been very agressive today but I haven't started the new medication. The doctor is encouraging me to give this a good month to see how he responds to the Seroquel.
I have read and reread your posts. You give me encouragement, practical,& straight-forward talk. I can hear your written voice in each post. There is something in your tone telling me you're here with me. What a relief you are!!!!!
Jo Ann

_________________
P. Jo Ann, 59, married 31 years to Richard, 78 yrs old. Richard was diagnosed spring 2008 with LBD.


Sat Dec 31, 2011 2:03 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: medications
Jo Ann, I am with you in your anguish and you are in my thoughts and prayers. PM me any time if you like. Hugs!

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sat Dec 31, 2011 2:13 am
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: medications
Jo Ann, I am so glad that the doctor is willing to work with you on this. You are a wonderful advocate.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sat Dec 31, 2011 2:29 am
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Joined: Wed May 06, 2009 10:15 pm
Posts: 15
Location: Kansas
Post Re: medications
Thanks, Jeannie. RD has a great doctor willing to listen. That helps both of us.

_________________
P. Jo Ann, 59, married 31 years to Richard, 78 yrs old. Richard was diagnosed spring 2008 with LBD.


Sat Dec 31, 2011 2:39 am
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