Treatment of aggression without neuroleptics

Discussion in 'I care for a person with dementia' started by Tensor, Jan 26, 2016.

  1. Tensor

    Tensor Registered User

    Jan 26, 2016

    My question is, are there other medications than neuroleptics to treat Alzheimer aggression with less side effects? (Not increasing mortality for example)

    fter a lot of stressful years we decided to bring our father to a nursing home because we couldn't handle him anymore (Especially the nights). They gave him antipsychotics for a short time but we were not happy with that idea because of all the bad side effects like higher mortality and increasing cognitive decline. Also we saw that cognitive side got worse over that period.

    But now he started to show aggression (probably had this to do with the toilet) towards the nursing stuff and they want to give him neuroleptics (Quetiapin/Seroquel) again. But isn't there an other solution for this situation?
    We don't want him to die earlier because of the medications. He is only 70 years old (First signs of Alzheimer started probably 8-9 years ago) And if there is no other solution, we probably would take him home again.

    Also how safe is the use of Benzodiazepine to handle sleep disorders of a Person with dementia? Is it as bad as the neuroleptics?

    Thank you for your answers.
  2. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    Hi, Tensor, and welcome to TP. I am sorry to hear about the situation with your father.

    I am not a medical professional so you'll have to take my advice for what it's worth, but do have some thoughts for you.

    First, though, may I please ask if you are in the UK, or elsewhere? I do not mean to pry, but as I'm in the States I have a better understanding of the system here, and many members from the UK will be able to better advise you if you happen to be resident in the UK.

    Also, has your father been diagnosed with Alzheimer's only, or with any other type of dementia as well?

    Many thanks, and best wishes to you.
  3. little shettie

    little shettie Registered User

    Nov 10, 2009
    Hi Tensor, I'm sorry I have no answers to your post but I know someone on here will. I would be interested in the replies too, particularly the sleep disorders.
  4. CJinUSA

    CJinUSA Registered User

    Jan 20, 2014
    eastern USA
    #4 CJinUSA, Jan 27, 2016
    Last edited: Jan 27, 2016
    Hello. Have you/they tried all over the counter options? Has acetaminophen or ibuprofen been tried? Has Benadryl (which has a relaxant) been tried?

    If this is Alzheimer's, is the main drug Aricept (donepezil) or Exelon (rivastigmine)? If Aricept is being used, perhaps adding Namenda to the medical mix might help improve cognition.

    Sometimes aggression comes with anxiety or fear, so perhaps the staff is behaving in just a way to trigger fear/anxiety and perhaps some other way of behaving is possible.

    When my father was suffering from vascular dementia back in 1992 to 1993, he became uncontrollably fearful and so agitated that he would pace for hours. He finally fell and ended up with crushed disks and a cracked vertebrae. He still wanted to get up and tear into things, and he would push us away if we tried to stroke him or hug him and get him to calm down. They finally put him on Haldol, a terrible antipsychotic drug. He died in a straightjacket in a hospital. No one could help him calm down, and even Haldol didn't work.

    I guess what I'm getting at is that if he is left to his own devices, your father might injure himself (or someone else), and he might have a fall if allowed to be ambulatory. Then you would be in a greater pickle. Like you, I wanted to keep him alive as long as possible, but now that I am in my ninth year with my mother at home with Alzheimer's, I wonder a bit whether longevity ought to be the goal. It seems that quality of life also matters. If your father seems happier when more complacent, then what hurt would the drug do? I imagine you don't want to hear that, but having been in somewhat similar circumstances, I can say that we all thought it a blessing for him that my father's heart finally gave out when it did. Pitiful to have to say that, of course.
  5. Lisa74

    Lisa74 Registered User

    May 27, 2011

    Hi Tensor,

    You could try an Anxiolytic- as you mentioned your GP could prescribe a Benzodiazepine.

    We use Lorazepam for my Gran and it works well- she has 0.5mg just before Sundowning at 6pm.
  6. Bod

    Bod Registered User

    Aug 30, 2013
    There comes a time when the current problem has to be dealt with, regardless of the "side effects".
    If medication will control the aggression now and keep him calm, then possibly, slightly bringing forward a mental down turn, is a price worth paying.
    Uncontrolled aggression will put him in a far worse place, mentally and physically.


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