First night on Olanzapine - akinesia

[Marmotta838]

Note - that should be 'Akathisia' in the title! Akinesia completely different..... Mother had her Mirtazapine increased from 15 mg to 30 mg three weeks ago. It has made her agitation and sleeplessness worse. So she was started on Olanzapine 2.5 mg last night. I stayed the night in the nursing home to keep an eye on her and it was a horror night. She could not keep any part of her body still - extreme restlessness and some 'jerks' which persisted even when she had some brief sleep from 2.30 to 5 am (known as akinesia). She was up and down out of bed about 40 times. Hyperventilating, panicky (she often has those anyway). Asking strange questions bordering on delirium (hasn't had these before). My question is will these side effects go away or does it mean the drug is not suited to her/not suited to her in combination with that dosage of Mirtazapine? I'm not sure I can stand another night like that and it's extremely unpleasant for her - should we push through it? It's a long weekend over here so can't ask her doctor. Nurses want to keep her on it - I guess she'll just end up in hospital if it gets worse tonight.....

 

[Adcat]

Gosh, I am so sorry your going through this. I'm not sure I can be much help but I didn't want to read your post and not reply.

Even though it's a long weekend, there must be a doctor on call for the nursing home? Perhaps you could ask for your mother to be reviewed? At least then you might get some peace of mind?

Thinking of you and take care x

 

[Tin]

In my experience, and only my experience, the more common side effects tend to pass in time. Its the less common ones that are a problem, whatever it is, it seems to 'make worse' what ever the dementia symptom is. Sorry, I'll have to try and make that clearer by an example.

Mum has completed a full week of no medication and I have noticed a big difference in her wandering/urge to move, she is still doing all this but not with the same manic intensity of a week ago, also noticed that sundowning times are not as bad. I know it has only been a week and there may still be traces of the medication in her. What is happening now is more night time wandering, try as I can, just cannot keep her in bed and last night had to give her a sleeping pill, mainly for my sanity, as she had been up and down for last 3 nights. Soon I have to talk with memory clinic to try and find a solution to this one.

 

[Marmotta838]

No medication?

Hi Tin,

Good to hear from you - have you taken your mum off all medication? The Memantine? Is that to find out what the baseline is? Did you decide to to do that or did the doctors? I would like to try this with my mother - see how she is without any psychotropic medications.....

 

[Marmotta838]

I went and saw an after hours doctor.....

Gosh, I am so sorry your going through this. I'm not sure I can be much help but I didn't want to read your post and not reply.

Even though it's a long weekend, there must be a doctor on call for the nursing home? Perhaps you could ask for your mother to be reviewed? At least then you might get some peace of mind?

Thinking of you and take care x

Thanks for your concern! I went and saw an after hours doctor and he said usually this symptom only gets worse so to take her off that anti-psychotic. Had to contact the acting head of the home who came in after hours and talked with me at length (he's a very kind man) and he had the authority to take her off it until we talk with the psychogeriatrician on Tuesday

 

[Tin]

Hi Tin,

Good to hear from you - have you taken your mum off all medication? The Memantine? Is that to find out what the baseline is? Did you decide to to do that or did the doctors? I would like to try this with my mother - see how she is without any psychotropic medications.....

Off all, the Memantine after only 2 weeks and 2 days, I found that as we increased each weekly dose her behaviour was becoming more manic, the restlessness, her obsession with dog, non stop chatter, paranoia and hallucinations started, she was convinced there were 2 girls in my car so set to shouting at them and trying to get them out. night time was a little better, but she was talking in her sleep and the urge to get out of bed was there. It was too much to deal with and other people had noticed it, so a week last Friday I called the memory clinic and they told me to stop and see if things calmed down, it did within 2 days. The Mirtazapine, well I have been a little naughty on this one because I had a gut feeling it was not helping at all, I slowly decreased it and then talked to doctor and he said that it would be ok to stop. The Mirtazapine was not helping or easing the massive obsession with dog and son and like you when we tried to increase things got bad. I hope we are not looking for a 'base line' because without these meds mum has been ok, still Dementia symptoms to deal with, confusion, wandering and sundowning but it is not as manic as a week ago. disruptive night time pattern has returned, so I have this last week, for the first time in ages, given mum a sleeping pill 3 nights on the trot. We have always had problems at night, usually 2 out of 7, but then just 1 sleeping pill would help, found I could deal with 2nd night of wandering by covering my head with duvet! Due to get a call from doctors next week and I am not sure what he will suggest.

 

[Tin]

Too late to edit my last post, anyway had a few hours to think and spoken to a few people and although still totally confused, especially about why mum was taking anti depressants in the first place, whether there was depression or if it was for the 'desired' side effects all has been lost in time. I think that if there was one out there that could help to ease the wandering and utter obsession with dog, son and sleep pattern, then that's ok. So yes I guess the medics are going back to baseline.