My mom seems to be having more hallucinations, delusional behavior and at times, paranoia. I know this is part of the disease but not sure if more medication is the answer. Neuro suggested Seroquel--which I am familiar with from working inpatient treatment programs. I just am not sure we should go down that road...but the line may have been drawn as she is now stating that my step-son has set up cameras in our living room to watch her, etc. She does live with us full time...and I don't want to move her to ALF...but this may be the time. Thoughts on adding this medication?
Hallucinations got worse, but I found several drugs that had been administered or re-administered the 30 days prior to the Hallucinations onset. I am and the new town doctors remove 5 drugs and or modified to lower Non-Long Acting Drugs. At first I saw, and Mom, saw major decrease of Hallucinations etc.
Recently Mom was admitted to Hospital, where they could see the January Psych Evaluation where she was clinically diagnosed (Jan 2018) as NOT Having Alz and or Dementia!
While in the hospital she became a problem patient and they started Zyprexa which made matters worse, Hallucinations etc! Prior to the Zyprexa they tried Trazadon with no success. The doctor would not listen to the nurses whom told the docs to try Remeron (Mirtazipine) (per the family knowledge of successful medications) at 1/2 the lowest dose 15mg (giving her 7.5mg near bed time). Since she has returned home I have started Trazadon around 1-2 p at 1/2 low dose. Then at Bed time I give the Remeron at 7.5 mg. As the side effects of increased desire to eat are also a benefit due to her being down to 87#’s in addition of the sleepiness it cause is a plus and it decreases OCB problems (a big plus in my mind).
I find this cocktail works better, not that she accused me of trying to poison her with meds today when she said she was sick at her stomach, which I presumed was a combination of her having indigestion (GERD) and lack of eating!
Mom’s Geriatric Psychiatrist went to the hospital and told the hospital doctors to stop administering Zyprexa, which they disregarded.
I have no majic answer, just the road I have been down!
Best of Luck to you and my prayers to you!
Bob
I can give you a little information on one of your frustrations. A UTI is diagnosed in two stages. First a very quick "dipstick" test is performed. It is inexpensive and fast, but not absolutely accurate. If it shows there may be an infection, the patient is started on a general antibiotic. Meanwhile, a culture is run on the urine. This generally needs to be sent to a special lab, and the culture needs to grow for a few days. When it comes back it will reveal exactly what bacteria are involved. This may result in a change of medications, to one that is specific to that particular bacteria strain.
So the common pattern is
Do a quick test.
If bacteria are present, prescribe an antibiotic.
Get a culture of the urine (which takes a few days)
If appropriate, change antibiotic to address the specific kind of infection.
I don't think your mom was "given the wrong antibiotic." Rather she was treated immediately but when more data came in, they switched her to a more effective med. I've gone through this with my mother, and recently myself.
A UTI is definitely one of those conditions that can mimic dementia symptoms, in people older than 65.
I understand your frustrations. My mother last July asked to go to an Urgent Care Facility one Saturday as she has bloody and painful urination and knew she had a UTI. Jumping forward two weeks she got a call from the Urgent Care Facility that they gave her the wrong antibiotic and she needed a different Rx. The next day after her first dose she awoke with chest pain. Being a cardiac victim (her and I) I went for nitro to which she said they were bad. Ended in a ED DX as GERD due to new antibiotic. Jumping three more days Mom had been back to ED for the third time, all three different medical reasons I noted with talking to PCP. This third visit the Facilty Attending ED MD said “the family has know your mother has had full blown dementia for YEARS!” The next two weeks the PCP and Neurologist examines and confirmed that they could state Mom did not have cognitive issues from as little as two weeks(PCP) and three months (Neuro), but something drastic had occurred! A month later we moved as planned, with a stroke while arriving the old home town. Again, different hospital where doctors and staff would not click the button that said careeverywhere, they DX Mom as having Full Blown Dementia. Months later a Full Neuro Psych exam was performed to DX NO DEMENTIA, but some form of cognitive impairment. The old doctors felt there was a medical condition the new hospital has given up searching for the root cause and presumes the causes are done from the stroke while moving. But the old doctors had already DX Unknown Altered Mind State in a matter of a few weeks! Mom is not the same Mom I had last June 2017. I am frustrated as the old Neuro said that their are a few medical conditions that can mimic dementia and once DX and treated that the altered mind state may clear up. The New Neuro says she is going to attribute this as a stroke that only affected her mind and not walking etc.
Bless you and best of luck!
Several times when I was much younger I have had doctors insist I need to take medication. When there is an alternative, I am all for that! One instance was for cholesterol - ditching processed foods and getting a bit more exercise took care of that without medication. The next was Fosamax for osteoporosis - I looked it up and read several articles about it and there is NO way anyone will get me to take that (or any of the other brands, they are all pretty much the same!) I was thankful I did know about that one when a vet wanted me to give one cat this crap. The alternative I found online with an Endocrinologist Vet was to eliminate the dry food (chow, kibble, whatever you want to call it.) THAT solved the cat's problem too!
Bottom line is I currently take vitamin D (stopped the calcium they pushed long ago as that can also cause more problems!) and 2 aspirin. That is it.
I would research all the current medications your mother is taking. Simply google the name of the drug with a keyword of Hallucinations OR agitation OR confusion.
In my mother case, documented as not having Dementia and now known to have Sundowners after hospital visits during and after a UTI, we found the following drugs to show a propensity of Agitation, Confusion, and or Hallucinations:
Zofran
Pepsid
Toprol-XL
Isosorbide
Pravastatin
I switched TorpolXL to 1/2 dose if old metoprolol
Stopped Isosorbide per MD
Stopped Zofran
Stopped Pepcid
Stopped all statins.
Doctors argued over the statins, but she is 86 years old, so I felt that the chance the statins being partially to blame it was worth the chance. We also ADDED Mirtazapine which has helped her sleep and got her weight up from 82# to 100 in eight weeks. Also I found she is hydrating much more, which I also Questioned Mild Renal Impairment, as her old doctor has been watching this since 2001.
Within five days Mom was thanking me for stopping the madness she was experiencing! I will say that six weeks later she said she was occasionally experiencing vivid dreams so we switched the Aricept to morning dose and then eight weeks later tapered her off the medication, as she does not have dementia but does have Vascular Disease.
Coincidentally we also took her off Diltiaziem (also on the list of causing confusion) and added a night time dose of Procardia XL at night and moved the Aspirin to nighttime dose as they think her BP was spiking in her sleep causing micro strokes (TIA).
Seroquel is not approved by the FDA for Dementia patients!
Now her drugs are administered and she is on the same original dose, 25 mg am, 50 mg pm. She has few delusions and few to no hallucinations. She does not seem so sleepy now. She has more muscle and leg cramps, but not sure there is a connection because she takes other meds too. She has greatly improved on the Seroquel and aricept.
being on Risperidone his hallucinations stop. i thought he was doing so well i started to
take him off of them. with in one or two days he was having hallucinations again.Put him right back on them.