Donepezil and aggression

Greenman

Registered User
Sep 29, 2016
14
East Midlands
My OH was diagnosed with AD in September and had a month of 5mg Donepezil and then went onto 10mg. She has been very aggressive on numerous occasions since then, we have issues almost every day which have been getting more and more out of control, to the point where I fear for my own safety. I have been doing my best to practice compassionate communication, which has probably helped with me cope but hasn't really helped my OH behaviour.

There is no sign of infection, been checked over twice by GP and had 2 urine tests. GP has referred her back to the memory clinic, we have an appointment next week, but I have spoken to the psychiatrist on the phone and they are suggesting that 10mg might be too much and would be better going back to 5mg of Donepezil.

Has anyone else experience of this? Should I be asking for other medication?
The psychiatrist asked me "what do I want them to do?" Like I'm the expert, surely they should be telling me.

I had a really good chat with our GP, hence the referral back to the memory clinic, and I spoke to one of the Occupational Nurses there last week who seemed to listen and was very understanding, but I'm now concerned that I'm going to fobbed off by the psychiatrist and will be back to square one.
 

Hellyg

Registered User
Nov 18, 2014
82
Midlands
Hello

My husband was on donepezil. He came off it recently in July, since then the aggression I had been seeing has reduced a lot, he also stopped work so stress has reduced too, so could be either...but I now think it contributed.

I think some medications work for some people and not so for others.

I would say note down behaviour you see so you can track changes and don't be afraid to state if a medication makes things worse rather then better.

I should say my OH has FTD Semantic variant so will respond different to medications than those with Alzheimer's
 

Bunpoots

Volunteer Host
Apr 1, 2016
3,790
Nottinghamshire
Hello Greenman

My dad's behaviour was really nasty while he was on 10mg Donepezil. After it was reduced back to 5mg the improvement was amazing.

I too was asked what I wanted to do. Big question!!! But we couldn't have carried on as we were...


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Polarbear

Registered User
Jan 17, 2016
17
Yorkshire
Hi Greenman, my dad was originally put on Donepezil in January just after his diagnosis and the change in him was frightening. He was extremely agitated, threatening to throw my mom out of the house and totally confused. He was taken off the medication after I suggested that the change coincided with when he started taking them. The memory clinic did say that it was unusual for somebody to have such a response but they did decide to put him on Memantine instead. As soon as he came of the Donepezil his agitation and verbal aggression subsided.
 

Greenman

Registered User
Sep 29, 2016
14
East Midlands
Thanks for your replies.

The memory clinic have sent us a prescription for 5mg so started OH on them last night, hope we get a good response.

Wishing everyone a merry and peaceful Christmas
 

Greenman

Registered User
Sep 29, 2016
14
East Midlands
It's certainly been a challenging Christmas! It all started so well, OH went onto 5mg on Friday night, all day Christmas Eve she was in a good mood and we even had some laughter and had a pleasant lunch at the pub. She went to bed and fell asleep by 8pm so I started to enjoy a bit a peace watching TV then it all kicked off, she woke up shouting and then spent the next 3 hours in a total rage. I can't believe someone so small can be so strong, I feel so helpless when she's like a wild animal. This was the closest I have come to calling 999, but yet again I didn't.

She finally went to sleep at 12.30 then woke again at 1.45 looking for some item that I had alledgedly stolen and hidden ( a common occurance). Once item was located she settled back down, then at 4.30 she got caught short going to the loo and soiled herself with bad diarrhoea, fortunately she had made it to the bathroom. So, by the time I had cleaned her up and the floor and washed her pyjamas it was too late to go back to bed.

I then had to cook Christmas dinner for us and the MIL having only had 3 hours sleep, so I found it difficult to muster up much Chrsitmas spirit. Fortunately last night she slept right through to 5.30, which meant I did too. But then today she's been grumpy all day and we had another 2 hour tantrum tonight, it's so exhausting trying to calm her down and distract her when she's constantly hitting, kicking scratching and spitting (it's the spitting I hate the most)

She's now asleep, and I've had another wasted day and haven't done any of the jobs I wanted to do around the house. If I'm lucky I can now have a few hours sleep before it all starts again.

Sorry, I know there's many of you going through this and more, I just felt like I needed to have a moan.

We've got an appointment with the psychiatrist on Thursday, I just don't know how I can explain what's happening in a way they will understand.
 

Bunpoots

Volunteer Host
Apr 1, 2016
3,790
Nottinghamshire
I would keep a diary of her behaviour and show it to the phsychiatrist. Just times and behaviours on a sheet of A4. I did something similar for my dad when his behaviour was causing us distress. The doctor kept it for his records.

If you could get any of the behaviour on video (smartphone) you could show that. But I imagine that would be almost impossible to achieve.



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Roseleigh

Registered User
Dec 26, 2016
291
I am new to this forum. Husband was diagnosed with AD last spring, but tbh he could have had a diagnosis at least six months earlier, but while he was functioning more or less normally I was more inclined to 'watch and wait', given that there is little standard drugs do to help.

He was put on donepizil but like several here I dont feel the effects are good. Its brought his personality back , to a point, made him more talkative (he'd actually been getting quieter and more passive for a couple of years before we even realised there was a problem), but its definitely made him more verbally aggressive, shouting at me at some point most days. Its brought no benefits whatsoever in terms of making him more capable of doing tasks.

I have now reduced him to half dose for the last three days and no improvement yet. Still hoping. Drugs can be slow acting.
 

ehaw

Registered User
Dec 27, 2016
4
Agression and other side effects

My father was prescribed 5mg Donepezil on 1st Dec. 2016 and we have a follow up consultation on 30th Jan 2017 to see about increasing the dose to 10 mg. To be honest I have seen an increase in my fathers aggression. I was tempted to take action but a friend with experience said be better to let things continue to the review. Regards side effects we got the information sheet and it mentioned various possibilities. In the first week of taking, my father suffered from uncontrollable bowel movements, they seemed to stop but they now seem to have returned (but may have been a one off or is unrelated.) It distresses him greatly and impacts his dignity and causes anxiety if we are due to go out. He accuses me of collusion with the doctors so the whole episode is not helpful. Has anyone had these kind of side effect experiences?
 

Roseleigh

Registered User
Dec 26, 2016
291
All my OH has had is a little nausea and stomach ache, which passed quite quickly. However the leaflet warns against diarrhea. I wouldnt give him the larger dose until it settles if I were you.
 

ehaw

Registered User
Dec 27, 2016
4
All my OH has had is a little nausea and stomach ache, which passed quite quickly. However the leaflet warns against diarrhea. I wouldnt give him the larger dose until it settles if I were you.

Thanks for the suggestion.
 

Roseleigh

Registered User
Dec 26, 2016
291
Probably the diarrhea will stop as his body adjusts to the drug. Best not to take him out in the meantime!

Also how about constipating foods? White carbs, bananas?
 

Archie17

Registered User
Apr 12, 2017
1
Donepezil causing nastiness or the disease?

My Dad was diagnosed with mild to moderate Alzheimer's in Feb 2017 and started immediately on 5 mg Donepezil daily.As he appeared to tolerate this,the dose was increased to 10mg daily after 1 month.Around 2-3 weeks after starting on the higher dose the problems seemed to start.He had already complained about needing to urinate frequently and then had a night of severe muscle cramps.I have since read that both these are reasonably common side effects of the drug.The real trouble started last week.On Wednesday my sister went to visit and all seemed fine with preparations for us to bring him away for a week's holiday.By the next day there was a complete turn around.He was being picked up by another family member (as it is a bit unclear if he is still ok to drive- we think not and it was a 2 hour plus drive) who mentioned not bringing a massive suitcase due to space in car.Well,this was like a red rag to a bull and to cut a long story short,a lot of abuse came out.My sister and I were accused of ambushing him to go to the doctors about his memory,never explaining what was happening,not supporting him and he has paranoia that some "third party" is deliberately coming between us.My brother in law told him he needs to be careful as he is having such an impact on the mental health of my sister and I but now he is accused of being threatening and making snide comments..It's just horrendous.He even told me yesterday that he doesn't want to see us again.My Mum died 6 years ago and my sister and I and our families are all he has.He has virtually no friends left.He has never been the easiest of characters and we had some difficult times with him for years even before his diagnosis but he had become increasingly withdrawn and more placid until this recent outburst.It's like something has set him off and now the floodgates are open with devastating effect.We are at our wits end.Neither of us live close by but we have honestly done everything we can - shopping,visiting etc.With his total agreement,we helped him to buy a retirement flat just round the corner from my sister which he was due to be moving into in 2 weeks time.We are all on board to help - he doesn't have to do anything on his own,but now he says he doesn't want to move...
I hope in some ways that this nastiness and complete turnaround is due to the effects of the medication because if it isn't I don't know how we will cope.We already have no idea which way to turn.If you have any advice or experience of this I'd be so grateful for your help.It's currently the middle of the night and I feel like my head's going to explode with it all.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
70,363
Kent
The Alzheimer`s medications had similarly negative effects on my husband and after trying them for a few months we took him off them. They are not suitable for everyone.
 

SoAlone

Registered User
May 19, 2016
137
Devon
I am so glad I found this thread. My OH has been prescribed Donepezil recently increased from 5mg to 10mg. I recently felt the aggression was getting so bad I have reported it to the memory clinic. I hated going behind his back but he tells me not to mention anything when they call around. They are now doing bloods to check for different medication. I have been actively encouraging OH to take it as it was sold to us as the solution to stopping a rapid decline in his Alzheimers. I think I will tackle Memory clinic regarding these reports now I think it is not just me being useless and winding him up. He bangs furniture and slams doors but I am worried this will progress to physical violence towards me and I could not cope with that
 

Lois Reynolds

Registered User
Oct 17, 2016
8
Hi
My mum is exactly the same as the above was diagnosed 7 weeks ago initially put on 5mg donepezil seemed fine no side effects , the going home issue stopped was still saying my brothers ( who are both dead and my dad also dead and who she divorced 32 years ago ) were there . She had her 4 week review and her dose was put up to the 10mg. 3 days in she's packing her bags again wanting to go home , she has lived where she has for 32 years . It's got alot worse she talks about her children but talks like it not one of them . The other day I asked her if she knew I was and she looked at me blankly . Age concern have been wonderful and been round a couple of tines and arrange to pick her up this week to take her to the day centre for 2 hours , she lied and said she want well and didn't want to go, the lady was fine about it Abd is going again next week . I asked my mum if she wanted to cone out with me and my husband tomorrow (good Friday) as we are both off work and are going out in car she said no because she doesn't know what tine they ( the family ) are going home , I didn't press her and left it at that . She isn't eating properly as she is waiting for the family to cone home before she makes tea, so unless we cook her something she eats toast and sandwiches . She has a freezer full of food she can cook in microwave but won't , tonight she said she will make something when I go , so I opened the door and left without saying anything I was so upset she has another review on wed and I'm going to ask them to take her off the medication as she is definately worse. She is only on 2 tablets a day ( 5 really but it's a battle to get her to take the 2) she won't take them unless we stand over her and watch and more or less force her to take them ( not physically) .
 

Leymoorlord

Registered User
Mar 22, 2017
12
West Yorkshire
Aggression

I'm not too sure whether it's the Donepezil which is causing the aggressive behaviour, having watched Dinkie's behaviour over the 18 months prior to her diagnosis, I found that a woman, formerly sharp, organizing, efficient and a whirlwind of efficiency in the home, had morphed into a depressive, self-absorbed creature, prone to sudden outbursts, when opinions clashed with hers, or lack of interest on the part of her immediate family was 'getting to her' that the 5'1" would become aggressive, to the point of screaming at 'life' with her face about 4" away from mine, or slapping my face, on one occasion spitting in my face during a tirade of disapproval. All this, often followed, within two minutes, by softly singing 'Abide with me' or 'Our Lord and Father of mankind', doubtless flash-backs to her upbringing by a devout Anglican mother, whom she is missing deeply. On one occasion I was confronted by such an outburst, which culminated in 'I'll take a knife to your f*****g eyes!!' itself a reflection on the five treatments to dear soul has ubdergone for Glaucoma and Cataracts.
Given that every single tablet or capsule is met with deep mistrust and endless debate from the former manager of a 'Health Food Store', I have to say, in fairness that the change to 'Memantine' has shown some improvement. We live in daily hope that things will remain manageable..
 

SoAlone

Registered User
May 19, 2016
137
Devon
I'm not too sure whether it's the Donepezil which is causing the aggressive behaviour, having watched Dinkie's behaviour over the 18 months prior to her diagnosis, I found that a woman, formerly sharp, organizing, efficient and a whirlwind of efficiency in the home, had morphed into a depressive, self-absorbed creature, prone to sudden outbursts, when opinions clashed with hers, or lack of interest on the part of her immediate family was 'getting to her' that the 5'1" would become aggressive, to the point of screaming at 'life' with her face about 4" away from mine, or slapping my face, on one occasion spitting in my face during a tirade of disapproval. All this, often followed, within two minutes, by softly singing 'Abide with me' or 'Our Lord and Father of mankind', doubtless flash-backs to her upbringing by a devout Anglican mother, whom she is missing deeply. On one occasion I was confronted by such an outburst, which culminated in 'I'll take a knife to your f*****g eyes!!' itself a reflection on the five treatments to dear soul has ubdergone for Glaucoma and Cataracts.
Given that every single tablet or capsule is met with deep mistrust and endless debate from the former manager of a 'Health Food Store', I have to say, in fairness that the change to 'Memantine' has shown some improvement. We live in daily hope that things will remain manageable..
I think it is Memantine they are thinking of changing my OH on to subject to blood test results. He has been a little more stable the last few days but I am constantly waiting for the next out burst. The constant tirade of the week before, has thank ful not repeated itself. . . yet. How do you cope with the threat of physical violence from one whom you love and who loved you? I am really concerned that if things reached this stage I would have to walk away? This seems cruel, but I don't think I could handle it at all.