My experience is practitioners push it like candy or say it’s extremely dangerous in the elderly. It accumulates in the body and can have increase in falls. My 88-year-old mother has difficulty with her mobility from arthritis and a spinal cord injury and cannot fully stand by herself, walks with a high walker. She has vascular dementia and difficulty sleeping, and anxiety. Have tried multiple drugs (melatonin, trazodone, and currently Seroquel) work at first, but then stop working or she has bad side effects. Currently have been suggested Abilify and risperidone. Any feedback would be extremely helpful ,thank you so much.
https://www.mayoclinicproceedings.org/article/S0025-6196(16)30509-2/pdf
My dad was diagnosed with bvFTD but his neurologist said his brain atrophy was consistent with several different kinds of dementia including vascular. He was originally prescribed benzos for his dangerous and very problematic behavioral problems. The two different kinds of benzos we tried (one, then another) actually made him much WORSE in different ways. One turned him into a maniac, the other into a non communicative zombie walking into walls. What worked best for him was Seroquel plus Trazodone for sleep. The dosages changed a lot over the 4 years he took them. When his obsessive behaviors increased, the Seroquel was increased. When his physical condition deteriorated and he lost strength, the Seroquel was decreased. I have not heard of Seroquel “stopping to work” but you know your mom best. Good luck!!
You mention leg spasms in one of your responses.
This made me think of the "miracle drug" I have now used for my husband for about 5 years.
We started using Trazodone to calm his anxiety and help him sleep at night.
I found, as a happy side effect, his regular leg tremors stopped.
It seems to relax the whole body.
It is relatively safe, non-addictive, and can be tolerated in larger doses than you really need. Ask the doctor about it.
Of course, everyone responds differently to medications, so it may take a few trials before you find what is effective for your needs.
Mom's PCP would not prescribe benzos as they are linked to falls.
They are also linked to causing dementia.
One thing to keep in mind with drugs like this, the patient can develop a tolerance, meaning the dosage may need to be increased over time, and they may develop withdrawal symptoms (more anxiety) when a dose is missed. That would be with regular, daily use. Occasional use can be pretty effective.
The drugs you mention, Abilify and risperidone are Not benzodiazapines, but antipsychotic medications. They can cause a side effect called tardive dyskenesia, or involuntary movements. And this class of drugs is not indicated for elderly dementia patients.
My husband with vascular dementia was prescribed risperidone, and developed the uncontrollable movements, and otherwise no noticeable effect on his mood or calming of anxiety. After stopping this drug, it took at least 6 months before the involuntary movements went away. One was moving his head from side to side. Try looking at something and moving your head from side to side. It will make you dizzy and unable to focus! I can't imagine how uncomfortable that had to be for him!
Yes, I would give the benzodiazepines a try. But I would not recommend antipsychotics for her condition.
If you decide to go that route, sounds like Valium would be the best. Shorter half life, can help with muscle spasms and other spinal problems.
Each patient reacts differently and the only way to tell would be to experiment.
The thing to watch for is that she doesn't end up on a drug cocktail with three or four or five different drugs. Be cautious.
But I'm going to share my experience with it.
We were having a very difficult time with one of my sons. Doctor put me on antidepressants and gave me ten Xanax. He was very careful to not get me addicted.
So anyways, my son burnt a hole abandoned mill down accidentally.
I'm sure you can understand that I was quite a mess.
So I took one Xanax, I literally felt so much at peace. I can tell you I never took another, because I new right then that I liked it, too much.
And I also know that if I'm ever in your moms position, I'd want Xanax.
I hope that was helpful to you.
Best of luck, so sorry about your mom
My father was diagnosed with Alzheimer’s over 10 years ago, and he is now in the later stages of the disease. He tends to experience agitation and aggression more than anxiety. He also previously exhibited sleeplessness and nighttime wandering.
Seroquel, 50 mg, and melatonin pretty much solved the sleep disturbances. Xanax, .25 mg, as needed resolved most of the agitation/aggressiveness issues.
When my father was first prescribed Xanax, I gave him half pills. .25 mg is the lowest dosage, so he was getting 1/2 of the lowest dosage. As he has built up a tolerance, I have had to start giving him whole pills, but he is still at the .25 mg level.
I have never given him the Xanax on a regular schedule. Instead, I only administer when needed. I’ve learned to identify cues for when his agitation is about to start and give him the Xanax preemptively. Usually by the time the agitation starts, the Xanax has begun to take effect and he will calm down shortly. It should be noted that my father has 24-7 care. He is monitored all the time, even when he is asleep, with cameras and pressure alarms.
At the low dose my father is on, I’ve never seen him “high” or unstable. He does have some balance/walking issues unrelated to the medication but, as mentioned above, he always has someone around to help him ambulate.
Some of my extended family members were initially critical of me choosing to give him Xanax. Indeed, I even had one who told me that I did not need to “drug him up just so you don’t have to deal with him.” After observing my father on the Xanax, she realized that I was not drugging him up and the only effect was that he calmed down.
Benzodiazepines have a bad reputation because they can be abused. Nevertheless, it has been my experience that if they are given at a low dose, only when needed, they can be extremely effective in reducing agitation and aggression.
Also, others have said, you have to try different methods until you find what works. Further, you should be prepared to adjust over time as things change (ie., what works now may not work later).
Yes, I know that your mother is not on a benzodiazepine; I am simply answeing your question.
Disclaimer: Not my authoring.
I would tell these practitioners that at 88, addiction isn’t a realistic concern.
Benzos can help a great deal with agitation, anger, anxiety and the like. Used appropriately, they can be wonderful mood stabilizers.
MOST people on Hospice (which you don't mention) have a cocktail of a benzo, or two and something for pain. Yes, you have to monitor the patient, but used in the proper dosage, can relieve the anxiety that is so often accompnying the aging process.
And some benzos (such as Klonopin) are considered to be quite 'clean'. They enter the bloodstream and do their job, then slowly exit, without the crash and burn of some of the other benzos.
Yep, it takes a bit to find what works. But right now, your LO is taking and OTC med (melatonin) and an old tricyclic AD (trazadone) and Seroquel, which can be super sedating.
A low dose of a real benzo may be helpful--but as always, check with the Dr.
i’m looking for peoples experience with benzodiazepines. Also, if there’s other combinations of drugs that have worked besides benzodiazepines would be very helpful.
yes, if indeed she was put on a benzodiazepine, she would be need close monitoring by practitioner. Healthcare ,the way it is today there is not close monitoring of anything for anyone.
for decades. It helps with anxiety. I was away and ran out of Xanax. It was 4 days until I got home to take a dose. I had no withdrawal symptoms other than being a bit anxious. Missing a dose will not put a person in withdrawal.
Good luck to you.