Husband with early Alzheimers: Question about medications

Posted by clayton48 @clayton48, May 25, 2016

My husband is 68 and was diagnosised with alzheimers two years ago, he has done very well and is currently on both donepezil and Namenda. He has complained recently of more anxiety and frustration. He is very alert in the morning but struggles as the day goes. If I ask his doctor to increase his medications would that help with his anxiety and frustration? He says he feels "on the edge" a lot. He is a very low key, quiet man. Any suggestions?

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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check her body language and her facial expressions. That really helps a lot if ya can

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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I have always respected my elders and now that she has this ugly friend with her. All the more reason as long as she isn’t hurting or hurt in anyway. Maybe that’s wrong.. but Miss Ugly has moved in and Ugly talks and yells. Those are things I just have never given any mind too. So I don’t engage when Ugly is present. I will stay two steps ahead of Ugly. And love my mom through it all.
That’s what I feel I have to do for her.
Oh in the early years I made up a game to play with mom. I would “lose” my coffee cup. I say mom have you seen my coffee cup. She would immediately start lookin for it. I always knew where it was. But it made her feel better about what she knew would move in her home. Her father had Alzheimer’s and he got combative but there wasn’t anything to help him. Mom has help. And I do remind her of that. Also because I know her so well, I am able to check her body language and her facial expressions. That really helps a lot if ya can be mindful of those 2 things.
God Bless

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@colleenyoung

@clayton48 we brought your questions to a pharmacist here at Mayo Clinic. She writes:

"Treating Alzheimer’s Disease can be difficult as some of the side effects of medications may be difficult to distinguish from signs and symptoms of the disease. Both donepezil and Namenda may cause anxiety, nervousness, aggression, confusion and fatigue. Depending on what his current dose is, and if the provider thinks these symptoms are from the disease rather than the medication, there may or may not be room to increase it. There may also be other medications to treat the new symptoms he is noticing. It is a good idea to keep an open line of communication with his provider regarding these changes and never hurts to talk about adjusting medication doses. Often times we see dose adjustments and medication changes in patients with Alzheimer’s disease as their symptoms change. You are asking great questions, and I’m glad to hear he is still doing well. It can also be exhausting to be the caregiver, so remember to take care of yourself, too! Best wishes."

@shellsk24 this is definitely in line with the experience you had with your father too, isn't it?

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Dear @randee thank you for your suggestions.  I liked your coffee cup game.  God bless you.

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@colleenyoung

Welcome to Connect @clayton48. What a great question!
I found this article about agitation and anxiety from Alzheimer's Association. It simply outlines possible causes, tips to prevent agitation and how to respond
https://www.alz.org/care/alzheimers-dementia-agitation-anxiety.asp
I'm also tagging fellow Connect members to join this discussion thread and share their experiences with Alzheimer's and anxeity. @salena54 @19lin @caregiver49 @mmurray22dad @denver90 @nhunter1217 do you have any thoughts or tips for Clayton?

Clayton - do you or your husband notice any triggers (time of day, lighting, medications, food, sleep, etc.) that might lead to the "on edge" feeling?

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I hesitate to recommend more medications, but it may be helpful to ask your doctor if an anti-anxiety/depression medication (hopefully one with fewer side effects) could make a difference. It was a good choice for my mother. (However, since her Alz. symptoms have worsened over the last year, so is her anxiety. At this stage in her illness, I'm not sure if increasing the anxiety meds are a good choice or not. Reading and implementing the tips recommended in the article about anxiety (linked above) have made a positive difference for us.

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I hesitate to recommend more medications, but it may be helpful to ask your doctor if an anti-anxiety/depression medication (hopefully one with fewer side effects) could make a difference. It was a good choice for my mother (in addition to Namenda and Donepezil. (However, since her Alz. symptoms have worsened over the last year, so is her anxiety. At this stage in her illness, I’m not sure if increasing the anxiety meds are a good choice or not. Reading and implementing the tips recommended in the article about anxiety (linked above) have made a positive difference for us.

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I cared for my father with Alzheimer's who complained of being anxious. He would rock back and forth in his chair. He'd say "I feel like I need to be doing something..." It was so hard and frustrating to him. His doctor would prescribe lorazepam (sleep) but what worked the best for him was vaping high CBC with small amounts of THC (medical marijuana). This did it -- it was the solution to our problem! I got my father a medical marijuana card in Oregon. And hands down -- after a few puffs, he would stop rocking and was able to relax. I do not recommend edibles or anything with high THC - because these give that head high. You do not want that with risk of falling and over eating. It must be high CBD and must contain tiny amounts of THC to make it active. This also helped with pain and headaches. It was a miracle drug for his anxiety and restlessness. He also enjoyed nature shows which helped calm him like Blue Planet series. I also made him Sleepy-time, Kava-Kava tea. This was one of the hardest jobs of my life caring for my dad with this disease but I was grateful to be the one to care for him. We had the best of times and the worst of times. My heart goes out to you for what you are doing. It is not easy... <3

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