Does anyone have experience of the use of this drug for anxiety (shouting out in distress for prolonged periods) Mum is on metazipine and risperidone prescribed by the CMHT and now she has been in hospital a psychiatrist has prescribed lorazapam. Inbetween these terrible anxiety session she is often quite drowsy so i hope this drug isn't going to deal with the problem by making her sleep rather than calm her.
Lorazapam for acute anxiety in dementia
- Thread starter ChristinaG
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In my experience, when I was giving this to my mum as and when her anxiety went out of control, it did make her sleepy. For us it was only a short term fix and after a while it began to have the opposite effect in that it made her very confused and a little restless, in fact I think it brought on the sundowning, But as I have been told over and over, it effects people in different ways.
Hi in my Mums experience even 0.5mg of Lorazepam is enough to make her quite drowsy, incoherent, and unsteady on her feet... but then my Mum reacts to most meds even on a very small dose.
My dad used to be able to tolerate it when needed for extreme agitation as a one off but as these episodes increased in frequency we had to give it more often and I think it ended up having the opposite effect. It does often make people sleepy but is quite quick acting so hence why we used it in volatile situations, although it never seemed to work quick enough for us.
A few years down the line he was given it again and it completely knocked him off his feet so there is no way I would give it to him now. Everyone seems to respond differently to different meds.
Dad had been on risperidone too but he had awful side effects from that and it did nothing to help his mood or agitation like it does some people.
A few years down the line he was given it again and it completely knocked him off his feet so there is no way I would give it to him now. Everyone seems to respond differently to different meds.
Dad had been on risperidone too but he had awful side effects from that and it did nothing to help his mood or agitation like it does some people.
Thanks for your replies. I have not heard anything good about any of the drugs they prescribe for anxiety. I have just stopped the nurse from giving mum lorazapam in hospital on top of the other two drugs. They hadn't even given her the pain relief to see if that would work so i asked if they could pl try that first as she may be in pain from the arthritis. It has worked over the last 3 or 4 times she was upset. That is the trouble now the drug has been prescribed nurses keep insisting on trying to give it to her when it was prescribed in hospital by someone who not only doesn't know her or her background but didn't even bother speaking to me. Poor mum she is so distressed and all they seem to want to do is knock her out. You are right about risperidone, it isn't any good. Too much knocked her out and half the dosage does little if anything at all. I can't help questioning the rationale behind prescribing these drugs. They seem to have a list and prescribe them without much thought at all. Sorry to be so negative but I've had a day if it at the hospital. I still feel the staff work really hard and are doing their best but i have to question why lorazapam? I was told it isnt permanent and doesn't build up in the system. I don't know what to think but i don't want them treating my mum like something that needs to be switched off because she is suffering from anxiety and is annoying.
Just to add they did knock out the lady in one of the opposite beds and she remained in a deep asleep through the night which was the intention but also throughout the day. Her relatives couldn't wake her even to eat or drink. She is in her nineties and was calling out.
Im not from the UK but Lorazepam seems to be the go to drug of choice when it comes to agitation & anxiety. The side effects considerable but generally quick acting.
When Mum was trialled on this for a week, initially worked but then just too sedating as mentioned earlier.
They then trialled Quetiapine ( Seroquel) as Mum was hallucinating and at times aggressive also. They did have Lorazepam as needed but I asked them not to ( I am Mums POA)
After a few tweaks it has worked well since Nov until now.
Mum was not super drowsy and still coherent.
These past few weeks Mum was admitted to hospital from her care home with acute delirium following a suspected UTI.
I say suspected as they could not get a sample frim her so they put her on anti bs as a precaution.
As Mum was majorly aggressive & physical to the point they had to call security, she was given shot of Halperidol & Lorazepam.
In this situation it was agreed by me.
Again worked short term but the side effects not pleasant.
Mum is back at her care home and her meds overall are being reviewed as to what is absolutely necessary. No doubt she will remain on Quetiapine for a while but its reviewed regularly.
In your Mums case, if the agitation and anxiety is caused by pain shouldnt pain releif be their first line?? Sounds like they want to give Lorazepam to make it easier for them
When Mum was trialled on this for a week, initially worked but then just too sedating as mentioned earlier.
They then trialled Quetiapine ( Seroquel) as Mum was hallucinating and at times aggressive also. They did have Lorazepam as needed but I asked them not to ( I am Mums POA)
After a few tweaks it has worked well since Nov until now.
Mum was not super drowsy and still coherent.
These past few weeks Mum was admitted to hospital from her care home with acute delirium following a suspected UTI.
I say suspected as they could not get a sample frim her so they put her on anti bs as a precaution.
As Mum was majorly aggressive & physical to the point they had to call security, she was given shot of Halperidol & Lorazepam.
In this situation it was agreed by me.
Again worked short term but the side effects not pleasant.
Mum is back at her care home and her meds overall are being reviewed as to what is absolutely necessary. No doubt she will remain on Quetiapine for a while but its reviewed regularly.
In your Mums case, if the agitation and anxiety is caused by pain shouldnt pain releif be their first line?? Sounds like they want to give Lorazepam to make it easier for them
If it wasn't for lorazepam, my mother would probably have been sectioned by now. When she goes into cornered animal mode -- either through my incompetence as a carer, a UTI, or because Dementia Says So -- 0.5mg usually calms her down... eventually. If I can find a way to get her to take it. Easier said than done.
Coincidentally I received another 14x1mg prescription today. It's maybe five months since the last prescription, so I really do try not to administer them just to make my life easier. But those 28 half doses are are a lifeline I wouldn't want to live without now. Seeing their effect on Mum converted me from someone who despised the idea of a chemical kosh to someone who understands everything has a time and place.
The time and place for healing is hospital, and nobody heals if they're getting no proper rest. That's not a licence to sedate indefinitely, but lorazepam isn't something to be scared of IMO. It gives a troubled brain a break which may have benefits beyond the initial sedation period. And we all know how traumatic and unsettling hospitals can be for our loved ones.
Coincidentally I received another 14x1mg prescription today. It's maybe five months since the last prescription, so I really do try not to administer them just to make my life easier. But those 28 half doses are are a lifeline I wouldn't want to live without now. Seeing their effect on Mum converted me from someone who despised the idea of a chemical kosh to someone who understands everything has a time and place.
The time and place for healing is hospital, and nobody heals if they're getting no proper rest. That's not a licence to sedate indefinitely, but lorazepam isn't something to be scared of IMO. It gives a troubled brain a break which may have benefits beyond the initial sedation period. And we all know how traumatic and unsettling hospitals can be for our loved ones.
I would agee that the underlying symptoms should be addressed. It seems hit and miss who gets sedatives and who doesn't. I think that, if tests need doing to find the underlying causes, and cannot be done because the PWD is extremely distressed, then a sedative or alternative may be appropriate. But any medication should be prescribed cautiously and with discussion with the family. As you say, if her underlying symptoms were addressed, she would no doubt be much calmer.
Some PWD or delerium are difficult to calm down and there are either no underlying causes or their distress is so considerable, due to their environment and their fear, that sedating meds are in their best interests.
If you mum is still in hospital, can you arrange to have a proper talk with the Consultant or is there a dementia nurse you could speak to?
On a general basis, lorazepam is supposed to be non-addictive but I found that, after a few doses (to help mum's insomnia), she became tolerant to it and it stopped working. But as has been said before, everyone is different.
All medication should be prescribed only when absolutely necessary, and in the PWD's best interests and, ideally, for their (and the family's) benefit.
Good luck.
Some PWD or delerium are difficult to calm down and there are either no underlying causes or their distress is so considerable, due to their environment and their fear, that sedating meds are in their best interests.
If you mum is still in hospital, can you arrange to have a proper talk with the Consultant or is there a dementia nurse you could speak to?
On a general basis, lorazepam is supposed to be non-addictive but I found that, after a few doses (to help mum's insomnia), she became tolerant to it and it stopped working. But as has been said before, everyone is different.
All medication should be prescribed only when absolutely necessary, and in the PWD's best interests and, ideally, for their (and the family's) benefit.
Good luck.
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I'm really sorry that your poor mum is still so distressed, and that the medication they have tried has not helped. I don't dispute what you say about your situation in the slightest. But neither do I want other people to dismiss trying some medication on because it hasn't worked in your mum's case.
Just for the record, risperidone has transformed my mum back from being constantly agitated and terrified that someone was trying to kill her, to relative normality. OK, she still has dementia and so is forgetful and confused but it has taken away the fear that was unbearable for her and me and quality of life for both of us is so much better. And she has had no apparent side-effects. Mum was tried on 2 other anti-psychotics before the risperidone and they had no effect whatsoever on her, so it clearly is the case that some drugs suit some people but not others.
I do hope that your mum finds some peace of mind soon one way or another.
Thank you for all your replies. Mum is still in hospital as she has had a couple of scares re further infections which turned out not to be the case and she couldn't open her bowels which is okay for the moment. She is not eating and drinking enough. All the time she is deteriorating and I'm told she needs a nursing home now rather than the residential home she was in which won't have her back after 5 weeks anyway. I wrote to the ward sister about the meds who was very sympathetic and said she will advise nurses to look at pain relief and poss constipation first before the lorazapam. I am very interested in the comments that risperidone and lorazapam works for some. Mum is also on metazipine on a regular basis. I guess everyone is different, it just feels like psychiatrists are just plucking these meds from a list on a trial and error basis with no rationale. There is no dementia advisor service at the hospital and to be fair they are doing pretty well considering the number of dementia patients they have to look after. The main difficulty is that it isn't possible to just talk to someone. There have been other glitches such as the canula not being put in properly by them (definitely not mums fault on this occasion) and mum was soaked with fluids when i came in. They forget that people with dementia cannot raise these things on their own behalf. My mum was just laying on the bed soaked and of course she wasn't getting much needed fluids. The problem has been removed now as mum whipped out the canula for the second or third time in the end. I honestly can't say they are doing a bad job in the circumstances with current resources though. It sounds perverse but i am glad to say mum isn't the only patient making noises so it isn't just mum causing problems but it is wearing on staff, me and of course poor mum. Like everyone else on talking point I have to keep supporting and speaking up for her. At least they haven't resorted to going on the attack which is what her previous Home did when i raised a concern - I can't tell you how distressing that was and so mean as they were serious issues. I think there are so many people with dementia in hospitals now that dementia wards should become the norm with more resources in terms of trained care staff to deal with the non medical problems.
