Not an exact science!

[candymostdandy@]

A quick recap.

Mum on Quetiepene which was not having much effect.

Asked Psychiatrist to increase dosage, would not as mum "as bright as a button, and if you can't cope you should be lookin at long term care"! also said "cannot medicate her for your benefit"..

Well after mum had a fall, had taken five casts off in 12 days, and staff on ward were not able to manage her as she would not sit still they changed the medication to Halperidol.

Mum came home, and it was a nightmare, became incotinent, was totally confused, we kept finding her on the floor (she hadn't fallen), so consufed that she used the shower as a toilet.

After a nightmare week, where one doctor told me to stop the Halperidol, and another to carry on with it, she ended up back in hospital..

While she was in hospital for 2 weeks, and on Halaperidol, she was totally confused, and unsteady on her feet, and again getting out of bed and lying onthe floor. Although unsteady on her feet she wasn't settling either during the day or at night...

Medication was changed on the second to last day of her stay to Promazine, she has now been home a week and what a difference..

She is calm, sleeps through the night, no more getting on the floor..

My first point, why change from Quietipane to Halaperidol instead of just increasing the dosage to start with.

The promazine was prescribed by the Hospital and not by her Psychiatrist, when I told the CPN the meds that she had been described, she said "thats a blast from the past we don't use that these days"..

Well its worked for mum, and thank God that someone had the sense to prescribe it instead of the "latest drug that we prefer to use"...

Mum has deteriorated, but she is certainly manageable, which she wasn't on Halaperidol.

 

[Grannie G]

Hi Candy,

It is frustrating when you feel you are not listened to, and when doctors seem to attack if they think you are telling them their job.

With all these drugs, thinking of the array of reactions just on this Forum, it is obviously a case of trial and error.

It`s so good something has been found that`s beneficial to your mother, and long may it continue to be.

Love

 

[ROSEANN]

Promazine

Hi Candy
Glad your Mum is a bit better I know how you feel.
My Husband was all over the place and was given Promazine and what a difference, so much so that he got back in to a sleep patten and for the last six weeks has not needed Promazine and we have been told to give them to him as and when he needs them.
Hope things keep okay for you.
Regards Roseann

 

[Canadian Joanne]

Blast from the past

I don't know what Promazine is, but Halperidol is definitely a blast from the past. All it did for my mother was totally screw her up bodily, slowed her down like a zombie, but she was still incredibly angry and physically aggressive. She simply did it all in slow (and sometimes NOT so slow) motion.

The doctor at the home prescribed it simply because it's a drug that's been around forever & so has he. It's the choice of old fogies, I think. It did no good for my mother. I had a major battle on my hands to get them to stop using it.

Glad that your mother is now on something that is actually helping her.

Joanne

 

[Nebiroth]

Unfortunately, with these drugs, it is often a case of trial and error. What works well for one patient will not work with another. What causes one patient no problems can cause severe side-effects with another. I don't think it's unusual, then, to try different drugs, rather than simply increasing the dose of one that isn't having the desired effect because increasing the dose carries a risk of side-effects. So it can better to try a low dose of something else instead.

Quitiapine is, I believe, the usual drug of first choice because it is one of the new class of medicines - sometimes called atypical antipsychotics - that carries less risk of side-effects than others. There is the difficulty that a lot of these drugs are no longer recommended for people with dementia. So the medics may have to fall back on older drugs, which carry more risk of side-effects.

I should think that is the likely explanation for the chain of events you list.

"Promazine" sounds as though it could be chlorpromazine?

It may seem paradoxical that you get a better result from an "old" drug, but that is the nature of this sort of thing. All they can do is to try the ones that "work better" for "more people" first, and work down the list until finding something that does the job.

Also, much depends on the experience and preferences of whoever is prescribing...

 

[Brucie]

"Promazine" sounds as though it could be chlorpromazine?

yes, chlorpromazine hydrochloride, chemically one of the phenothiazine derivatives.

It worked for Jan for quite a time, with no obvious ill effects.

Clearly depends on the person, their stage, the dosage, what else they take, etc.

 

[Margarita]

http://www.alzheimers.org.uk/Working_with_people_with_dementia/index.htm

Click on neuroleptics Risperidone and olanzapine: restrictions on use for people with dementia , say a lot more about drugs