18+ months on Respiridone, any advice?

saucepan

Registered User
Jul 30, 2014
40
0
Hi
My Dad is 83, diagnosed with Alzheimers 2 years ago and living in care home for 18 months. He declined very rapidly after diagnosis.

He is on Respiridone (anti physicotic), Mirtazapine (anti depressant), Memantine (moderate to severe Alzhimers), Donepazil (Arracept) Warfarin (blood thinner). He sufferers a lot with urnine infections, has quite a few chest infections, sleeps most of the time, and has become more and more unsteady on his feet (9 falls this year) And his walking is very shuffly and he can't manage to walk very far at all.

He recently had a review from Mental Health care team who have decided they are going to try and reduce the Respiridone again. They tried this before over 6 mnths ago, and his aggresive behaviour came straight back. The aggresive behaviour is all related to his personal care, needing his pad changed or showering. It got to the point where it would take 4 of them to get him changed, and he would be exhausted after each out burst. So they decided to up the dose again.

They are also going to stop the Donepazil.

I know that the Respiridone should only really be used for 6 - 12 weeks maximum and that is necessary to watch carefully for balance problems which he clearly has. I am also aware that losing the ability to walk is part of the progression of the disease. The sleeping a lot, apart from medication, I am sure is to do with his depression, age and progress of disease.

Any change in any of his medications previously he has reacted very badly to.

Does any one have any advice for me? Do you think I should ask for no changes to be made, insist that they stop the Respiridone, try another type of drug, eg. anti anixety instead of anti phsychotic. Any questions I could ask the Mental health team, people at care home, or his GP?

Thanks in advance.
 

Shedrech

Registered User
Dec 15, 2012
12,649
0
UK
Hi saucepan
the question of meds is, to me, a balancing act
dad's on Respiridone too, and has been for a while - and as with your dad, he had some very challenging times before taking it, and I would hate him to undergo those again - but we do wonder and worry - he's also much less mobile = the shuffle and his balance is going - BUT as far as I could see, his mobility was decreasing before and his balance issues, him feeling unsteady, have been there quite some time; I don't think anyone now, for dad, could untangle what's going on
so if I were you, I'd agree to the reduction but only if your dad is carefully monitored and they are ready to increase the dose again - and certainly talk with the CPN about your concerns and whether there is an alternative
dad is also off Donepezil and now takes Mementine, and a different anti-depressant
I really do think that it's worth talking over all your concerns with the mental health care team and GP to settle your mind
 

jorgieporgie

Registered User
Mar 2, 2016
1,982
0
YORKSHIRE
Hi,
I am very concerned about risperdone my Mum is going to start taking this today after been on Lorazapan. She is a bit unsteady on her legs sometimes but otherwise she is quiet mobile. I am frightened this makes her worse.
The CPN said it would take the voices away that she hears and that would stop her getting upset all the time. No anti-depressants prescribed though.
Everything is worry where med's are concerned, but they did say that they were going to monitor her for six weeks.
 

Canadian Joanne

Registered User
Apr 8, 2005
17,710
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70
Toronto, Canada
As Shedrech says, it is a balancing act. My mother was on anti-psychotics for many years, as she had a very agitated and aggressive disease progress. We gradually reduced her medications, starting with her antidepressants.

Jorgieporgie, I was more concerned about the lorazepam than the risperidone, as lorazepam is addictive. With all meds, we need to carefully monitor them and the effects on our loved ones.
 

LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
My husband was on 1.5mg daily of risperidone for over 4 years - he was very carefully and regularly monitored. He was lucky in that he never suffered any side affects - it didn't even make him drowsy. He was also on trazadone for anxiety and agitation (and in the hope it would help him sleep. Nope!), Exelon patches and later on, Ebixa (Memantine) in liquid form.
 

saucepan

Registered User
Jul 30, 2014
40
0
Thank you for your repsonses. Talking to mental health care team and monitoring is obviously my best bet.

Last night had a serious fall and is now in Intensive care with multiple facial fractures. So other worries for now.
 

Shedrech

Registered User
Dec 15, 2012
12,649
0
UK
oh my goodness saucepan
what a concern for you
I hope your dad is now comfortable
and that you managed some sleep last night
best wishes to you both

sorry I wrote this before seeing your new thread
what a situation
I hope the medics can help your poor dad
 
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saucepan

Registered User
Jul 30, 2014
40
0
oh my goodness saucepan
what a concern for you
I hope your dad is now comfortable
and that you managed some sleep last night
best wishes to you both

sorry I wrote this before seeing your new thread
what a situation
I hope the medics can help your poor dad

Thank you Shedrech.
Dad is in a bad way after his fall, surgury isn't an option and along with other medical issues, we have asked the doctor to stop all treatment which she was in complete agreement with. He is now just on morphine, something to calm him and oxygen. We are now waiting for him to pass on, which is hard, but his suffering will soon be over.
 

LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
Oh saucepan, I'm so sorry for your loss. Dreadful for you, to have that last final trauma of the fall. Condolences to you and your family.
 

Kjn

Registered User
Jul 27, 2013
5,833
0
I'm so sorry saucepan. Please accept my condolences x