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 Trazadone 
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Joined: Sun May 13, 2012 4:31 pm
Posts: 11
Post Trazadone
Got some upsetting news today. My dad has been in a nursing home for just over a year and has been doing as well as we could expect. He still knows who we are and enjoys are visits. My mom goes every day at 11 and gives him fruit, coffee and a donut or apple strudel. We also push his wheelchair around the grounds of the nursing home. Other family members go on the weekend. We have no complaints about the care my dad is receiving and trust the doctor who prescribes the minimal medications to manage my dad's condition. The problem is the better he does the more aggressive he becomes and although he has lost over 70 lbs is still quite strong. He has been on a minimal dose of Haldol and has been receiving Trazadone at night.
A week ago there was a sudden change. He slept during a good part of our visits and had difficulty drinking even his favourite coffee. Mom asked if his medication changed and was informed by the nurse it had not. Monday, i found out that for the past week he had been given a quarter tablet of Trazadone at lunch time to combat aggressiveness. Mom spoke with the doctor today and he confirmed he was getting Trazadone at lunch to combat his aggressiveness and have been told we might be nearing the end.
I realized that staff have to be kept safe but at the same time, the negative change in my dad as a result of the addition of the trazadone. I also wish staff would have informed us of a medication change so that we could deal with the changes in dad.
I'm still ok with the care my dad is receiving but worry for my mom who is finding it increasingly more difficult to visit daily when there is little response from my dad. A few weeks ago she said he still had her but she did not have him.
All we can do is continue to support her and to visit dad as often as possible as long as we can.


Thu Jun 27, 2013 5:40 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Trazadone
I would be more apt to blame the Haldol rather than the trazadone.

I do empathize with your mother and know just what she means. There is no meaningful response from my husband during my daily visits. When he isn't sleeping, he is babbling incoherently and if he addresses me at all it is usually in anger and often doesn't know who I am. There is nothing but heartache in this disease. I pray that there will be a medical breakthrough soon! Too late for us but it would be wonderful if others never had to go through what we all have.

_________________
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 Jun 27, 2013 6:19 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3423
Location: Vermont
Post Re: Trazadone
Hi - I'm sorry for what your dad and your family are going through. A couple of thoughts about some of the issues you raised:

1. Who is your dad's medical POA? That person should be asked, or minimally, informed about any changes in meds. I believe that in many states a person's meds cannot be legally changed without consent of the POA, so his POA should have been aware of the change BEFORE it happened. You may want to check this out with his atty. and then make the dr. aware of that if you feel that's important.

2. Yes, the CG's safety is an important issue and if medicating your dad more is the only way to ensure their safety, that may just have to be the way it is. There are any number of discussions on here about people getting kicked out of ALFs and SNFs because of their aggression, and it sounds like this is not something that you'd want to have happen. Maybe you could ask the dr. if the dosage can be tweaked some so that he isn't groggy. That may not be an option but it's worth asking.

3. Re: end of life. Has he been evaluated for hospice services? If he passes the hospice criteria, getting their help may be a good thing for him, your mom and the rest of you. It may also be helpful to the family to have their brochure which describes the behaviors and other important things in a person's final year. I find that the more informed I am, the better I can deal with what is to come. I wish I'd had that brochure many months before I got it from my dad's hospice nurse.

It's good that your dad has so many supportive family members by his side. Remember to take time to take care of yourself, too, and same for your mom. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Thu Jun 27, 2013 6:50 pm
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post Re: Trazadone
Yes if it were me I would have to say the blame lies with the Haldol, I am not saying Trazadone can't be the drug doing the harm but I woild be concerned with the small amount of build up of the haldol over time.
I am sure you have seen this before but in case you haven't I will post again !


Neuroleptic sensitivity, in which striking and irreversible
parkinsonism can evolve shortly after use of neuroleptics, has led to
the recommendation that conventional neuroleptics should be avoided in
patients with Lewy body dementia (LBD). For example, Haldol is known
to cause life-threatening effects in a LBD patient. Neuroleptics have
caused severe adverse reactions such as cognitive reduction,
parkinsonism, heavy sedation, and neuroleptic malignant syndrome. Even
the newer 'atypical' neuroleptics may or may not work in any given
patient although there are some reports that Seroquel, Zyprexia, and
Resperdal have been successful in treating problematic hallucinations,
delusions, or agitation in patients. However, unless it is
contraindicated, cholinesterase inhibitors such as Aricept, Exelon, or
Reminyl

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Irene Selak


Sun Jul 07, 2013 11:13 am
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