No suitable medication

[switzerland]

My husband has advanced Alzheimer's disease, he is only 68 and was diagnosed 10years ago. He is in a nursing home and was prescribed anti psychotic risperidone about 2 years ago for agitation. He has not been reviewed by the psychiatric team since. He gets very distressed every day rubbing at his head and grinding his teeth, he has rubbed a large area of his hair so that it grows very slowly. The gp prescribes co codamol which has no effect, he is also on lorazepam, citalopram. Does anyone else recognise these symptoms?
Nice guidelines say risperidone is for short term use only but I have been requesting a review for many months and no one seems to listen. Any advice anyone? I am struggling to cope with seeing my husband so distressed.

 

[Alicenutter]

My husband has advanced Alzheimer's disease, he is only 68 and was diagnosed 10years ago. He is in a nursing home and was prescribed anti psychotic risperidone about 2 years ago for agitation. He has not been reviewed by the psychiatric team since. He gets very distressed every day rubbing at his head and grinding his teeth, he has rubbed a large area of his hair so that it grows very slowly. The gp prescribes co codamol which has no effect, he is also on lorazepam, citalopram. Does anyone else recognise these symptoms?
Nice guidelines say risperidone is for short term use only but I have been requesting a review for many months and no one seems to listen. Any advice anyone? I am struggling to cope with seeing my husband so distressed.

Maybe check the use of Lorazepam? I know that I have taken this myself (prescribed for anxiety at the time) and I am very reluctant to take it except in an emergency as it has had a very negative effect on me the next day - extreme tension and irritability. Just a thought….

 

[stanleypj]

I would certainly consider asking for a review of all the medications as they could, alone or in combination, be having an adverse effect. As far as the risperidone is concerned, as you say, it is not being prescribed in accordance with the guidelines and you should ask about this.

 

[switzerland]

Medication.

Maybe check the use of Lorazepam? I know that I have taken this myself (prescribed for anxiety at the time) and I am very reluctant to take it except in an emergency as it has had a very negative effect on me the next day - extreme tension and irritability. Just a thought….

Thankyou it is useful to know that.

 

[Toddleo]

Nice guidelines say risperidone is for short term use only but I have been requesting a review for many months and no one seems to listen. Any advice anyone? I am struggling to cope with seeing my husband so distressed.

Interesting post Switzerland, my mum is also on Citalopram, Lorazepam and Respiridone too, and, like you I have concerns about her being on Risperidone for such a long time (now over 8 months), I am mindful of the NICE guidelines and I suppose I should organise some kind of medication review for mum, but there's just not enough hours in a day, that coupled with the thought of taking mum to the surgery/the issues with getting an appointment, etc.....

 

[switzerland]

Medication

Interesting post Switzerland, my mum is also on Citalopram, Lorazepam and Respiridone too, and, like you I have concerns about her being on Risperidone for such a long time (now over 8 months), I am mindful of the NICE guidelines and I suppose I should organise some kind of medication review for mum, but there's just not enough hours in a day, that coupled with the thought of taking mum to the surgery/the issues with getting an appointment, etc.....

Does your mum have any side effects? I think if it is working don't knock it, but it is very hard to know what is the disease and what is the drugs.

 

[Toddleo]

Does your mum have any side effects? I think if it is working don't knock it, but it is very hard to know what is the disease and what is the drugs.

Yes I agree. On the whole the benefits of her medication far outweigh the side effects. It is hard to know what are side effects, and what is the alzheimers?
The main issue with mum is the constant pacing and inability to sit for more than 5 minutes in a day, she just wanders and wanders around the house, unable to settle to anything. But, this does tend to manifest itself in the afternoons, and I think it could be sundowning - who's to say really?
I would be interested to have any update from you if you can organise the review of his meds. Best of luck moving forwards.

 

[switzerland]

Yes I agree. On the whole the benefits of her medication far outweigh the side effects. It is hard to know what are side effects, and what is the alzheimers?
The main issue with mum is the constant pacing and inability to sit for more than 5 minutes in a day, she just wanders and wanders around the house, unable to settle to anything. But, this does tend to manifest itself in the afternoons, and I think it could be sundowning - who's to say really?
I would be interested to have any update from you if you can organise the review of his meds. Best of luck moving forwards.

Will let you know, as you say it is hard to know what is the disease and what is drugs.

 

[Toddleo]

any updates?

Will let you know, as you say it is hard to know what is the disease and what is drugs.

I was thinking about this thread the other day as things have taken a turn with mum.

The day centre have suggested that a medication review is urgently carried out, they feel that mums CONSTANT pacing and inability to concentrate on anything (including eating or drinking), plus the way she stands has now altered (she leans backwards all the time - one of the medication leaflets - not sure which one- talks about 'altered gait' as a side effect) could be due to medication side effects. We have asked for an urgent review of the Lorazepam, Risperidone and Citalopram, and hope that this will get done today....... The day centre can not cope with her until we get on top of this, so I am desperate for some kind of adjustment/cessation of these meds and, I suppose, trying something new? who knows.

Any suggestions from those of you who have "been there". Many thanks

 

[switzerland]

Drugs review

I was thinking about this thread the other day as things have taken a turn with mum.

The day centre have suggested that a medication review is urgently carried out, they feel that mums CONSTANT pacing and inability to concentrate on anything (including eating or drinking), plus the way she stands has now altered (she leans backwards all the time - one of the medication leaflets - not sure which one- talks about 'altered gait' as a side effect) could be due to medication side effects. We have asked for an urgent review of the Lorazepam, Risperidone and Citalopram, and hope that this will get done today....... The day centre can not cope with her until we get on top of this, so I am desperate for some kind of adjustment/cessation of these meds and, I suppose, trying something new? who knows.

Any suggestions from those of you who have "been there". Many thanks

Good luck with the review, I am still waiting for my husbands review after four months!!
He is now on a pain patch in case his agitation is caused by pain.

 

[Toddleo]

Good luck with the review, I am still waiting for my husbands review after four months!!
He is now on a pain patch in case his agitation is caused by pain.

will update on here when I know more.....
I did find this link re Lorazepam and Ripseridone being taken together, but I suppose everything can be found online if you look for it!

http://www.drugs.com/drug-interactions/ativan-with-risperdal-1488-899-2019-1305.html

 

[Toddleo]

risperidone update

For those following this thread. We had the medication review for mum today, and they have told us to stop the resperidone with immediate effect. The medication is causing an unusual gait (mum's standing very oddly) and akathisia (this is all the fidgeting, restlessness and compulsion to keep moving.) I expected the drug to be weaned off slowly, but apparently it is just to be stopped outright. The psychiactric nurse will visit on Monday to check out how things are going...Very interesting all in all, and we shall see what effect this has on all our stress levels!