I started my Mom on a new med two nights ago (Trazodone 50mg) to help with her sleeping during the night, as she was awakening me many times during the night for about two weeks or so, thinking it was time to get up. A few times she would remark that her Mother had been with her, or her sister had come, (both deceased) but mostly it was just her mistaken belief that it was time to get up. I would escort her back to her bed, and she'd promise to stay there until morning. Of course it didn't happen. Thus, I called her Dr. for advice. He prescribed the 50mg. of Trazodone. I gave it to her at 9PM Thursday night. She slept until 5AM. I thought that was great progress. BUT, when I saw the condition she was in the following morning (yesterday) I was somewhat alarmed, as she was extremely confused, hallucinating, talking to people who weren't there, and not understanding that I couldn't see them, and off balance walking, and talking complete nonsense with scrambled words at times. She continued that way throughout the day. More confused and bizarre acting than I'd ever seen her act before. It was to the point that I felt unsettled to let her out of my sight too long. When I called the Dr. about this, I was told by his nurse (who didn't confer w/ the Dr. I might add) to just cut the dose in half. So, last evening, my Mom went from being rather fun and bubbly (still very confused and seeing people) around the dinner hour, to agitated, confrontational, and speaking about people being in the room with us, and why wouldn't we ask them to leave! She asked my husband who he was. She wouldn't stop talking. She was reluctant to take her Trazadone dose, and go to bed, when just a half prior she was all ready for bed. This confrontational behavior has never been present before. I had to really do some talking and cajoling to get her off to bed. She seemed very unsettled, still talking about this unseen man, who I told her was one of her guardian angels, hanging round to protect and guard over her. (this was 9PM) At 11:30, just as I turned my lights out, she began her up and down process, and it continued almost every half hour. At one point she had accidentally pushed the lock on her door, and I awakened with a start to our dog barking, as she pounded on the door to be let out!! I had to calmly talk her into unlocking her door, and when we finally got it open she burst out asking where all the people had gone who were yelling and being noisy in our living room. It was a freaky and unsettling night for all. Meanwhile I did some reading on Trazodone, dementia, behavioral issues, and I came upon an interesting piece regarding DELIRIUM. It sounded like what Mom is experiencing. Some meds mixed w/ others can cause delirium. (Mom is on Digoxin, and has A-fib. Trazodone can mess w/ heart rhythms, I read.) Delirium can be the result of an infection too. I'm wondering if Mom has a UTI. OR, and I guess this is my main question, could this very sudden strange and perplexing confrontational and agitated behavior be just a new phase of her dementia?? All of those things were listed on the serious side effects of Trazodone....but she's only taken two doses. 50mg the first night, and 25mg the second night. It's Saturday...so I really don't want to take her to the hospital for this, because there's a flu outbreak in town, and I don't want her sitting in an ER waiting room exposed to a bunch of germs. She is agitated, but I think I can keep things under control, just will mean no sleep. Should I STOP the Trazodone until I get things figured out? I am really confused as to what to do next. How dangerous is delirium, if that's what it is? Thanks for listening. Thanks ahead of time for any help. Braida
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Seroquel was a wonder drug for us. I wonder what we would have done without it -- I'm pretty sure it would have meant a care center. But I also know that for some people with dementia it is neutral, and for others it makes things worse. Each brain is unique to start with and then is also individualized by the dementia damage. It can be very difficult but highly worthwhile to find just the right drug or combination of drugs for a given individual.
Braida, I hope you'll come back and let us know how things are working out. We care!
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It often takes a period of trial and error to find the right med. Captain doesn't like seroquel. My mom has been taking it for two years and to me and other caregivers I know it is a miracle drug and works as it should. Mom started with 12.5 mg and has gradually increased to 75 mg. A few weeks ago I increased it to 100 mg because she was delusional and we are about due for an increase in dosage anyway. Then I decided to take her to the doc to check for a UTI, which of course was positive. After a few days on the antibiotic, I reduced the seroquel again and all is back to as normal as we can be around here. When we started seroquel doc said that he has some dementia patients on up to 400 mg a day.
good luck, I hope you find out that the cause could be due to a UTI which is much easier to deal with than the change you have seen the last few days.
in reply to your question , yes , i think that the natural progression of dementia can result in phsycosis turning on one day with no prior warning. my mom became delusional about 2 months before her death and never really came out of it. the tranq , haldol , kept the agitation down but the paranoid delusions and hallucinations never stopped.
Anytime my parents have needed to go to the hospital, I have called 911 for an ambulance. It cost a little bit, but it bypasses triage. I've heard that the waits in the ER waiting room can be long on busy days. I don't want to put an elder or myself through that, particularly if the elder was not behaving rationally. That would be too difficult.
The onset of symptoms as soon as she started the Trazodone does make me believe the drug (or dosage) didn't agree with her. The doctor can check for a UTI and other things, but I would still suspect the drug. I hope you can get it sorted out and she goes back to normal, but sleeping through the night.