Vascular dementia and the use of Trazadone for aggression

[Poppy Field]

Hi, My mum has vascular dementia and has been in a nursing home for the past six months. She has had a turbulent time having to cope with a fractured hip within a few days of arrival at the nursing home and more recently partial amputation of her thumb from an accident. In spite of her poor mobility due to a TIA and seizure last year, fractured hip and subsequent falls, she has been determined to walk. I often find her walking slowly up and down the corridor with her frame and pleased to see me. I so admire her indomitable spirit and take my hat off to her.

My mum has been prescribed lorazepam for agitation as and when required. Worryingly I have been informed that my mum has been hitting out at staff and residents off and on. In a meeting at the nursing home, several 'triggers' have been discussed. I have been asked to consider a Trazadone for my mum's aggression. I am concerned about its dizzy side effect when my mum is susceptible to falls.

I would like to ask what positive or negative experiences have been encountered with the use of Trazadone for those being cared for with vascular dementia. Many thanks.

 

[nellbelles]

Hi @Poppy Field welcome to TP

I see you have received no answers to your posts and I didn’t want you to think you are being ignored.

I personally have no experience of Trazadone, and although online it is suggested as a antidepressant and anti anxiety medication I cannot see much that is helpful to your questions.

Maybe you need to talk further to the Doctors involved in her care.

I hope someone with knowledge of this drug will post soon..

 

[MrCanuck]

My mom had Vascular Dementia that came to light after a fall and broken leg. Her sudden paranoia (someone trying to kill her) resulted in her not being able to stay in her house and we had to move her into memory care.

She did not settle well and was quite agitated. She was not aggressive, but the paranoia was there along with panic attacks, poor sleeping and depression. To deal with the agitation she was put on Seroquel which had weird psychological effects and physical side effects and she was quickly taken off it.

This was replaced by Trazodone. She had one dose in the morning to help her with the daily agitation and a slightly larger dose in the evening to help her sleep. She was on Trazodone for 2 1/2 years. In that time she had one fall in the bathroom. Over time she picked up a forward and left lean when walking (she had to use a walker, when I saw her walking without it - she often claimed she didn't need the bloody thing - I would hold my breath) but I'm sure that was not related to any meds. She was also on Memantine during this time.

So, from my personal experience Trazodone did not increase my mom's fall risk, and was a beneficial medication for her. But remember that everyone responds differently to medications, and anytime a new med is added you need to keep a close eye for any problems, and if there are multiple medications involved be careful of how they interact together. I'm sure the Seroquel would have killed my mom had she been kept on it but the Trazodone was a blessing in our case.

My mom passed away in March from a blood infection.

 

[Linbrusco]

My Mum has been in a care home 2 yrs.
Unfortunately UTI's result in Mum developing delirium, and resulting agitation, agression and anxiety.
Last year ( first UTI) when things didnt resolve Mum was trialled on a low dose of Lorazepam on waking when she was at her worst.
It didnt do much other than to make Mum a bit less agaressive, but sedated, unsteady on her feet and had slurred speech.
Mum was already on Nortriptyline at night for sleep and nerve pain. It is an older type of anti depressant too, so they stopped Lorazepam, and increased her Nortriptyline. It had no effect.
GP & Mental Health Team decided to trial Quetiapine ( Seroquel). With a few changes in dose, this worked for our Mum without making her sedated. Her mood could still be a bit up and down, but it was manageable.

March this year, Mum developed another UTI and acute delirium. This time she ended up in hospital. It was a complete nightmare. Agressions and agitation through the roof. Not nice to hear that hospital staff had to call security to get Mum, and take her back to her room
Once discharged back to her care home, we had a medication review, with Care Home Manager, GP, and Mental Health Team.
As Mum was refusing meds off and on, it was decide to withdraw her Cholesterol & overactive bladder meds. Reduce her Nortriptyline and increase her Quetiapine. Mum is now on 25 mg on waking, lunchtime and bedtime.
The change in Mum has been a massive improvement, now coming up 10 weeks. Her quality of life is so much better...... if only we can keep those darned UTI's away

I know this is nothing to do with Trazadone, but just to give a different perspective on how the same drugs can have different effects person to person. I strongly beleive though, that sometimes its not the drug itself but interactions with other drugs they are already on too, and to always start with a minimal dose of any new drug.

 

[Grannie G]

My husband was prescribed Trazadone. I`m sorry I can`t remember how it helped but he was taking it for a while so it must have been of some help otherwise it would have been stopped.

These drugs are trial and error because everyone is so different, different medical conditions, different forms of dementia, different metabolisms. They are not a solution to the problem but they may help.

 

[Hazara8]

Hi, My mum has vascular dementia and has been in a nursing home for the past six months. She has had a turbulent time having to cope with a fractured hip within a few days of arrival at the nursing home and more recently partial amputation of her thumb from an accident. In spite of her poor mobility due to a TIA and seizure last year, fractured hip and subsequent falls, she has been determined to walk. I often find her walking slowly up and down the corridor with her frame and pleased to see me. I so admire her indomitable spirit and take my hat off to her.

My mum has been prescribed lorazepam for agitation as and when required. Worryingly I have been informed that my mum has been hitting out at staff and residents off and on. In a meeting at the nursing home, several 'triggers' have been discussed. I have been asked to consider a Trazadone for my mum's aggression. I am concerned about its dizzy side effect when my mum is susceptible to falls.

I would like to ask what positive or negative experiences have been encountered with the use of Trazadone for those being cared for with vascular dementia. Many thanks.

Antidepressants are used when appropriate, of which Trazadone is one. As always, 'best interests' for the person who presents with agitation or aggression should be made clear to family with regard to any drug. My late mother, during severe moments of paranoia received antidepressants, which did not result in any worrying outcome with regard to falls, but clearly, with any susceptibility to potential falls, a resident should be observed if not accompanied during their 'walks' if this is a risk. As medications affect individuals in such varied ways, one cannot offer a true perspective on Trazadone, albeit there will be posts here who can attribute to its effect no doubt. From a personal standpoint, the usage of antidepressants when the need arose with my late mother, was a positive move. Certainly preferable to an antipsychoitc drug which was once administered with notable side effects.

 

[Lindy50]

Hi Poppy Field and welcome to TP
I would echo others' comments that drugs tend to affect everyone differently, and even vary in their effect on the same person at different times......so the whole thing really does have a huge element of trial and error to it.
I hear what you say about your mum's mobility, how hard she's worked and how much it means to her. Whether she tries Trazadone seems in the circumstances to depend on how aggressive she is. Are there any other adequate ways of managing her emotions and behaviour? I do hope so.
My personal experience is that mum, who has vascular dementia, was put on Trazadone when she was extremely aggressive, biting and scratching staff who were trying to give her personal care, and shouting out day and night to the distress of all around her (and exhausting herself in the process). It did seem at first to have some effect, however this soon wore off and it was stopped.
Basically time, individual care and patience have been the only things to help her. Medication, in her case, seems to have little effect.
I cannot say how or whether Trazadone would help your mum. I'd say talk it through with the GP if you can. I really hope you can find a good solution soon that does not affect your mum's mobility.
All the best
Lindy x

 

[Anjel20]

Hi
my dad was on trazodone I did not keep him on it long was not eating sleeping constantly day and night he ended up in home they put him on it again which I was very reluctant about he has been in home two months and lost two stones in weight was 9stone when he went in now only 7 they are now taking him of it so if they do put your relative on it just keep an eye on there weight or get weight updates don’t actually no if the trazadone has caused this with my dad or not also when he went in two months ago he could walk and shuffle about a bit but now he can hardly walk don’t no if that’s the trazodone but something is definitely not right.the home says he is sleeping all day and up at night so instead f getting three meals a day with other residents they are having to feed him at night and they say he is loosing out on food because of this also they say some days he sleeps around the clock and they can’t get him up or he tells them to go away by the way when he first went into home he was being aggressive to hence why they put him on trazodone they had to take his walking stick away as he was trying to hit them with it he also tried to smash his room window with it and he was attacking them with a toilet brush

 

[Cat27]

Hi @Anjel20 & welcome to TP
Such a worry for you. I wish you strength.
Please keep posting as you’ll get lots of support here.

This thread is from 2018 so I’m closing it.