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    As a carer for a person living with dementia, the needs of the person you care for will often come before your own. You may experience a range of difficult emotions and you may not have the time to do all the things you need to do. Caring can have a big impact on both your mental and physical health, as well as your overall wellbeing.

    Angelo, our Knowledge Officer (Wellbeing) is our expert on this topic. He will be here to answer your questions on Thursday 29 August between 3-4pm.

    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

Antihistamines as sleep aid

Discussion in 'I care for a person with dementia' started by MERENAME, Nov 20, 2016.

  1. MERENAME

    MERENAME Registered User

    Jun 4, 2013
    238
    scotland
    My Mum has been waking and getting up 20+ times a night. Dr said try giving her an antihistamine but it doesn't seem to be doing any good. He wasn't very specific and I will have to talk to him again but I wondered what other peoples experiences were and which antihistamine they used? Everything seems to have so many side effects.
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,636
    Female
    London
    Ther are drowsy and non-drowsy antihistamines. I have to say though that the drowsy ones didn't aid my sleep, they just made me lethargic, so I ditched them. Have you tried any herbal sleeping pills?
     
  3. Tin

    Tin Registered User

    May 18, 2014
    4,829
    UK
    I've never tried this, although people have suggested it to me. Occasionally I would give mum some night nurse and it did seem to help, but not recently. It might be worth having a chat with pharmacist, if you do this make sure you tell them about any prescribed medication.
     
  4. Slugsta

    Slugsta Registered User

    Many of the mild OTC sleep aids, and ingredients of cold/flu remedies that aid sleep, are antihistamines.

    I take an old fashioned 'drowsy' antihistamine every night and they do help me sleep although they are not foolproof.

    The problem with giving this kind of thing to the elderly in general, and PWD in particular, is that they can increase the risk of alls.
     
  5. marionq

    marionq Registered User

    Apr 24, 2013
    5,755
    Female
    Scotland
    The usual antihistamines like Loratidine have no effect. The ones prescribed for my husband acted like knock out drops. The combination with other medication made them too powerful and I stopped them. Zopiclone 7.5 mg would probably make her sleep,but be drowsy next day. A couple of nights sleep though might be worth it.
     
  6. MERENAME

    MERENAME Registered User

    Jun 4, 2013
    238
    scotland
    Thank you. I will go back to the Dr. The visit was for a different problem so I didn't ask which ones. I wasn't aware at that point about first and second generation antihistamines etc. It's good to hear real experiences with the various drugs as they all seem to potentially affect the dementia and it's difficult to weigh up the pros and cons when you're not really clear about them in real life.
     
  7. marionq

    marionq Registered User

    Apr 24, 2013
    5,755
    Female
    Scotland
    Just dug out the antihistamines the doctor prescribed - promethazine hydrochloride 25mg. These are only to be taken at night. On their own they would probably be fine but in combination with some other drugs they are too strong.
     
  8. mancmum

    mancmum Registered User

    Feb 6, 2012
    385
    People on mumsnet are positive about night nurse

    There's a long thread on mumsnet about people knocking themselves out with nightnurse.

    I am now an expert on pain relief having had both a hangover and raging abscess toothache at the same time. I might try nightnurse tonight.
     
  9. dottyd

    dottyd Registered User

    Jan 22, 2011
    1,066
    n.e.
    I used to bring diphenhydramine back from America. First I was on one a night, then two then three.

    It got me through a bad time but then I read bad things about them. Possible risk of memory loss etc so stopped taking them.
    Wish I never had now.
     
  10. la lucia

    la lucia Registered User

    Jul 3, 2011
    591
    I'm a bit concerned about some of the suggestions which may be fine for you or me but not a pwd.

    Herbal medicine can interact with other medicines and be problematic, and from what the op describes, the problem is not actually a sleep problem but a disturbance problem which is quite different.

    I know there's some great GPs but for things like this I would ask for an appointment with the community mental health team. They have specialist knowledge of dementia and medications.

    My mother used to get up repeatedly through the night (15+ times) and once she had a stroke it became dangerous because of the risk of falls. My GP had prescribed sleeping pills but they didn't work for more than a couple of nights.

    The community mental health team arranged for a consultant psychiatrist to visit and he explained that it wasn't insomnia it was an 'urge' that woke her up. He prescribed a low dose of Mirtazapine but said that it doesn't work for everyone. At a low dose it targets a receptor in the brain that triggers the urge. It has the opposite effect at higher doses (it hits different receptors).

    Luckily it worked for my mother and she now sleeps through the night except when she has a UTI. It's great because she's alert the next day, she engages more with people and one useful side effect is it makes her hungry! I had terrible problems getting her to eat before.
     
  11. LynneMcV

    LynneMcV Volunteer Moderator

    May 9, 2012
    3,464
    south-east London
    My husband also takes Promethazine, not as a night medication (he sleeps very well at night) - they were prescribed to be given 'as and when needed' should he become overly agitated.

    They make him totally zonk out. The first time I gave him one he slept the rest of the day and dozed on and off throughout the next day or so too. I was shocked at their strength. He has had them about five times since last March and each time my husband has continued to be quite sleepy for about 36 hours, making him a little unsteady on his feet.

    I can see how they would work for someone who has trouble sleeping but it is worth knowing how long it can take to wear off too - though of course, on another person, the effect might not be as long lasting.
     
  12. Tin

    Tin Registered User

    May 18, 2014
    4,829
    UK
    How low was the dosage? mum has nbben taking 15mg Mirtazapine for a few years now, with just a few weeks of trying to up it with no success.

    After all these years I am still finding the sleepless nights hard to deal with.
     
  13. la lucia

    la lucia Registered User

    Jul 3, 2011
    591
    My mum is on 15mg. I think some can tolerate 30mg with the same level of 'urge control' but higher than that and it doesn't do the trick.

    I found quite a good research paper on it not long ago where it was tested on pwd groups.


    I give my mother her Mirtazapine about half an hour before bedtime. It's great because she's not 'hungover' the next day. I've got a small supply of sleeping pills to use on an 'as needed' basis in emergencies but I haven't needed them so far.

    The consultant did emphasise that it doesn't always work for everyone. If it failed for us he was willing to gently trial other things.

    But I have to say he's an awesome consultant with a very profound understanding of the nature of dementia. I feel very lucky because as some of you know, I was on the floor with exhaustion.

    I hope you find a workable solution. No sleep totally kills me.
     
  14. MERENAME

    MERENAME Registered User

    Jun 4, 2013
    238
    scotland
    I e mailed and have spoken to the CPN who is going to speak to the consultant tomorrow. He suggested a few antidepressants that might be suitable. One of them was mirtazapine. I think this is the right way to go rather than sleeping pills. Fingers crossed that it stops the urge to get up and generally chills her out so we can enjoy this last bit of time we have together. There are so many challenges on this journey. Love to you all, Susi x
     
  15. Tin

    Tin Registered User

    May 18, 2014
    4,829
    UK
    I am going to do the same tomorrow, talk to memory clinic because I really do not think the mirtazapine is helping with the sleeping thing - at mum's last appointment I asked if we could try a different anti depressant, but he wanted to 'up' mirtazapine first.

    I am still on the floor - need to get this evening stuff sorted.
     
  16. MERENAME

    MERENAME Registered User

    Jun 4, 2013
    238
    scotland
    The paper la lucia shared suggests that quite a lot of people didn't respond to 15mg but did to 30mg. After reading it I'm convinced that it's worth trying both dosages if needed as it seems to have less of the potentially troublesome side effects than some other options.
     
  17. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Dad wakes a lot oh lord I can hear him now ah back maybe it was a loud yawn
    GP not interested just said it's dementia get a night carer or think about a home. I was fuming.
    He was on trazadone but gave dad vivid dreams so off that. Now amitriptylene but does nothing at all
    The mental health team visited and good but didn't recommend any meds. They said the best medicine is making sure they are worn out by sending them to daycare
    Dad won't go so any sleeping ideas I'm listening ...
     
  18. la lucia

    la lucia Registered User

    Jul 3, 2011
    591
    Sedation disappeared when the dosage was increased from 15 mg to 30mg [p7].

    There's no magic answer to the problem but possibles. The paper is a tiny study that is dealing with agitation on a more serious scale not just at night.

    I think the big take-away from the paper is that for an off-label use of the drug (it's not meant for people with dementia), it had no nasty side effects. But 15mg seems to be the optimal dose for the sedation effect.

    Probably wisest to keep an open mind but fingers crossed the consultant or cpn will work with you and your mother to find a solution.
     
  19. MERENAME

    MERENAME Registered User

    Jun 4, 2013
    238
    scotland
    "Sedation disappeared when the dosage was increased from 15 mg to 30 mg in a patient and they could continue the study." Whilst that sentence doesn't really make sense I read it as referring to just one patient. Given the small sample, only 7 were given the increased dose, it is a high % but would mean sedation didn't disappear in 6 out of 7.

    You are of course right that there is no magic answer and honestly some of the professionals I have come across haven't got a clue. Thank you for sharing as it has clarified my thinking. I will need to wait until tomorrow to see what the consultant says but my Mum's anxiety is affecting her quality of life and even if it doesn't help with sleeping I think that the time has come for anti anxiety medication.
     
  20. Tin

    Tin Registered User

    May 18, 2014
    4,829
    UK
    Now that kind of statement from the medical health team would just make my blood boil. My mum does not go to a day care facility, but I keep her busy, busy, busy. From 9a.m and still we have the sleep problems through the night.
     

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