Use of anti psychotic drugs

Discussion in 'Middle - later stages of dementia' started by athrawes, Feb 10, 2015.

  1. athrawes

    athrawes Registered User

    Sep 11, 2014
    2
    Hi all,
    I am new to the forum. My dear mum, 72, has now moved in to a nursing home following a huge deterioration of her dementia in the summer which culminated in a section. After five months in hospital, she moved into the home in December. My dad just couldn't cope any longer. Initially she settled in well, but after 8 weeks there has been a significant deterioration. In the mornings she is violent and screams and runs around the corridors in a great deal of distress. This is a daily upheaval. She does settle after a hour or so, but getting her dressed is the trigger for this aggression. There has been a review of her medication and an anti depressant has been introduced, but this has been ineffective. The doctor has today suggested introducing an anti psychotic. I have heard some negative comments about the use of these. Does anyone have any advice please?
     
  2. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,498
    Female
    Near Southampton
    #2 Saffie, Feb 11, 2015
    Last edited: Feb 11, 2015
    Hello and welcome to TP.

    Sometimes a shortish course of antipsychotic drugs can help calm someone down.
    In hospital my husband became paranoid and aggressive and was prescribed a low dose of rispiridone. I was horrified and protested but have to say that it did help though I'm not convinced that it didn't increase his confusion and hasten his dementia deterioration.

    He was on it for around 4 months and never needed it again.
     
  3. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Sleepless night Saffie?:( Me too)

    Welcome to TP athrawes.

    My OH had anti-psychotics-on and off for nine years. I won't go into his medical history as it went on for what seemed forever! However, to address your dear Mum's problems-at least the trigger has been identified. My OH had anti-psychotics because he DID actually experience psychosis-he wasn't given the meds because of resistance to personal care. It is very important that dressing/washing is given in a calm and peaceful manner. Two Carers are best-one to distract and one to do the deed. Sometimes my Husband needed three carers:eek:If you are certain the care is given correctly I can only advise to speak to the medic who prescribed the meds.

    Voice your concerns-always remember that you are your Mum's voice. I became quite good at becoming a total pain when I wasn't sure that things weren't quite right.:)

    Good luck

    Lyn T XX
     
  4. Grey Lad

    Grey Lad Registered User

    Sep 12, 2014
    5,736
    North East Lincs
    Risks Associated with Anti-psychotic medication

    I have extracted from an article in New Scientist (2009) that points out the risks associated with this medication:

    The risks, however, are large.
    According to the UK Medicines
    and Healthcare Products
    Regulatory Agency, the
    medication produces a threefold
    increase in the risk of stroke
    (www.bit.ly/NN8p0). The drugs
    also double the risk of dying over
    a three-year period, according
    to a study funded by the UK’s
    Alzheimer’s Research Trust (The
    Lancet, Neurology, vol 8, p 151).
    Last week, 10 dementia
    groups, including the trust,
    demanded the UK government
    publish a long-delayed review of
    the use of antipsychotic drugs
    in dementia.


    Hope this helps. G L
     
  5. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,992
    Suffolk
    OH was put on antipsychotics during a spell of vivid delusions, accompanied by threatened violence. He was only on them for 7 weeks, but it was a high dose and he has 6 small TIAs in that time. I have refused for him to have them again.
    I think they have their place, but only in the short term. Also individuals react differently to drugs. You don't know til you try!
     
  6. nitram

    nitram Registered User

    Apr 6, 2011
    19,261
    Male
    North Manchester
    You say that your mum was sectioned last summer and was in hospital for five months.

    Have the hospital team been involved in the medication review?
     
  7. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,149
    Toronto, Canada
    I have always said that anti-psychotics can have a use if they are carefully monitored. Some people are so extremely agitated, aggressive and/or violent, that there is no other recourse.

    We have just weaned my mother off the last of her anti-psychotics a few months ago. She had been on them for nearly 14 years - of course, the type and the dosage changed over the years.

    If your mother is very distressed in the morning, why don't they wait for an hour or two before trying to get her dressed? If she breakfasts in her pyjamas and everyone else is fully dressed, that might cue her to get dressed. I don't think it's the end of the world if she is not washed and dressed on the home's schedule. I do understand the home's point of view but my mother's home was willing to leave my mother in bed when she absolutely refused to get up till the afternoon. I told them to keep her hydrated and leave her be.
     
  8. arightcat

    arightcat Registered User

    Jan 7, 2009
    8
    York
    Hi athrawes,
    I've been where you are with my mum - she's a bit younger than your mum (66) but she deteriorated rapidly and was sectioned in Feb 2013, and in hospital until Nov 2013 before being discharged to a care home. I totally sympathise with where you are - it is hideous :( In my mum's case was given enough medication to anaesthetise a horse and it still didn't calm down the violent and aggressive behaviour she was showing.

    I believe that antipsychotics have a place as a last resort and only short term - but sometimes for the safety of carers and the patient's own safety they have to be used. My mum was hurting herself and others. Eventually after much tweaking of doses of medication they got her a bit calmer. I do feel that they kept her on the cocktail of meds for too long though. Her dementia seems to have moved on and although she is still very unpredictable, she is no longer mobile which means in some ways she is less of a danger to herself and others. Personal care is still an absolute nightmare though.

    I hope that you find something that helps your mum, it is a horrid situation, Lx
     

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