Antihistamines as sleep aid

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

  1. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Thank you Just written to GP asking for a referall back to mental health team I can't do this night waking much more I am drained
     
  2. marionq

    marionq Registered User

    Apr 24, 2013
    5,791
    Female
    Scotland
    Merename and others - since this topic has been raised again I'll give you my update. We did discuss that promethazine 25 mg prescribed by our GP knocked John out and was too strong but I noticed that liquid Night Nurse also discussed had only 10 mg of promethazine. I bought it but had not used it when two weeks ago I had to call out a locum on 111.

    John had a slight chest infection and I asked the doc if he thought the NN was safe to give on top of the antibiotics. He said yes so I tried a couple of times when he was restless. Worked very well and no side effects next day. I will keep it as a standby for difficult nights.
     
  3. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    This sort of advice should be written in stone.

    My GP suggested paracetamol (fair enough) and warm milk. Eventually he gave me a few zopiclone and that broke the cycle. Now I get 7 tablets about every 6 months and only use them sparingly. In fact she spits most of them out and they are wasted (dissolve instantly in water). So I cut them in half and try to disguise the disgusting taste in icecream (but it still tastes awful).

    My standard night time procedure is:

    - paracetamol suspension (she cannot handle the big tablets), about 500mg dose
    - warm milk with half crushed NYTOL
    - Deep heat rubbed into her calf & knees.

    Sometimes the above works OK. She may need putting back to bed a few times. I put her on her back & pile on the blankets (I think if she can warm up enough before she gets the 'urge' to get up she may fall asleep).

    If all else fails I go for the nuclear option. Zopiclone in icecream (it really is bad).

    I think the mirtazapine option sounds sensible. From what has been described the GP won't prescribe, so I have to get a referral to 'old people's mental health'.

    MUm is also very agitated and constantly blows raspberries during the day. I wonder if the mirtazapine could help with that....if it reduces anxiety.
     
  4. marionq

    marionq Registered User

    Apr 24, 2013
    5,791
    Female
    Scotland
    Thanks Crazyweather. I use Night Nurse sparingly. If John has a night where he starts talking about getting ready for work and panicking about his "piece" ie packed lunch then I give half dose of NN. Perhaps once a week on average ? It definitely gives him a soothing sleep with no apparent after effects.
     
  5. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    Crazyweather, thanks for the warning about Nytol...I shall bear that in mind.

    The problem I have is that if I go to the doctor he may say that 'warm milk' is strong enough and tell me not to use Nytol. I don't think the Nytol is having much of an impact on mum.....but I am using it every night now....'just in case'. I crush half a tablet in milk and she drinks about half the milk....so quarter of a tablet, I guess (Original type). I think I will continue to self medicate....unless I think she is unsteady & at risk of fall....I will also try to reduce the usage. But it is tricky to spot when she will be unable to sleep until it is too late.

    It's not that I distrust the doctors but I think their hands are tied & they err on the side of caution, they don't want to increase the risk of falls. But the carers suffering with disturbed sleep is OK....or so it seems. Sort of like the collateral damage of dementia.

    I think Mirtazapine 10mg could be worth trying but it sounds like I have to find a way around the doctor in order to try it on mum for a trial period.
     
  6. Al_B

    Al_B Registered User

    Jun 8, 2016
    9
    Male
    Manchester
    The other thing to bear in mind is that all drugs affect people in different ways. My OH is on 10mg Mirtazapine and she sleeps all night but can be drowsy during the day.
    My dad who is in his 90s and fit says that paracetamol knock him out.
     
  7. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Seeing as GPs well certainly mine is no help it's no wonder people try their own methods
     
  8. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Unfortunately my dad is not mobile and I can't drive and have no other family so reliant on the said GP
     
  9. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    I was OK until the last comment. Sounds a little judgemental....probably wasn't meant to be. Not everyone has a choice in where they end up, some don't have the resources to get out of the hole they find themselves in, some don't have the energy to start digging for the light. Some of us have to make do with what is available and muddle through. Being told that 'my doctor' is wonderful probably doesn't help. Maybe 'get another doctor' would.

    I followed advice and went without Nytol last night. Could have been a coincidence but was very agitated....had to give zopiclone in the end. So back to Nytol tonight.
     
  10. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    CW, I will try weening mum off Nytol. Her agitation last night may have been because she wanted to pooh. There was a big pooh waiting for me in the morning. I did check her before I went the zopiclone route last night....sometimes you cannot see anything but there might be a whiff of something coming....there was nothing.

    So I'm gonna stick with weak Nytol but investigate Mirtazapine for anxiety. But my doctor isn't much help, so I will probably have to fight to get a trial period of Mirtazapine.

    When you have to fight to get things then eventually you give up & let the doctor get their way.
     
  11. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Hope you have some luck
    I'm plodding on chasing the GP for a referall back to Mental health team
    If no response I'm calling them direct.
    Saying that dad slept the last 2 nights but normally that's the calm before the storm
     
  12. la lucia

    la lucia Registered User

    Jul 3, 2011
    591
    Hi sorry if I am repeating myself but the GP is not the place to go for this. As I said a few pages back, it's the Community Mental Health Team who manage the medication for dementia problems. Ring and ask for an appointment.

    But there's no magic solution, including mirtazapine. It's a trial and error process during which you cannot administer ANY other non-prescribed medications.

    This is off-label prescribing... ie not prescribed for its usual type of problem. And how a pwd reacts may vary. That's why it's trial and error. If one trial fails you can maybe try something different. GPs are not able to prescribe off-label.
     
  13. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Some of us are struggling to get to speak to our mental health teams as we have to be referred by our GPs. That's certainly the case for my dad even though he had had a referal before and they said no meds case closed if you need help down the line get your GP to refer you
     
  14. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    I thought everything had to go through the GP too....although someone said that you can self-referral to old people's mental health (OPMH). Mum was under OPMH for a time when she was on Aricept/Donepezil but they gave her care back to the GP when she got too bad (which didn't make sense to me). So it is all very confusing....as soon as I think I understand how the system works I find that things have changed due to cut-backs.

    I don't think OPMH have enough resources, that is why they are handing care back to the GP. So it will be interesting to see how they view self-referrals.
     
  15. WORRIER123

    WORRIER123 Registered User

    Oct 1, 2015
    1,174
    Round robin eh
    You have same issues as me
     
  16. oilovlam

    oilovlam Registered User

    Aug 2, 2015
    388
    South East
    Just tried to self-refer to 'old people's mental health' (OPMH) and was told to get lost....well not exactly....they just said that they don't take self-referrals and to get a referral through GP. So it's back to GP to try to get him to agree that mum could be a candidate for Mirtazapine. County is Hampshire btw.
     

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