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Anyone have some experience with all this? Trying to figure this out, and include a balance with risks is getting more complicated all the time. So..what do you all think of the possibilities. I have only been offered 5 possibilities ...but, I am sure there is more experience here with more.

Gabapentin. Known as a mood stabilizer. It also have the possibility of some amount of pain control. Even though this is usually used for nerve pain, the studies done on It for mood control seem positive. The draw back it that the ramp up to clinical levels is pretty slow. Could be a could weeks before a positive benefit is achieved...or it might not work at all.

Zoloft. Even slower to work than Gabapentin. Takes several weeks before being effective..if at all

Haldol. This is a drug that will definitely fix the agitation and aggression...but carries a serious heart risk. Since my dad is already seriously effected by COPD and Congestive heart failure...this seems like too high a risk to me

Risperdal. The benefits of haldol, but still a risk for heart patients. Maybe this might be needed in the future...but any added risk seems to me to be a choice that is in Column B. For now.

Anyone have others to offer? What experiences have you have with them? How do you get them to take the meds?

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Katie
I was loathe to use any of these anti-psychotic drugs with my 93 year old mom but with her move to memory care this year I had to agree

While hospitals seem to go to Ativan it is very sedating - haldol is a first generation anti-psych drug which she was given in an inferior hospital setting and acted like an elephant tranquilizer on her

As she is a huge fall risk, I reluctantly agreed to a small dosage of seroquel at bedtime - it also is used off label as a sleep aid

After 3 months it became necessary to add seroquel during the daytime and it completely knocked her out - however with continuing UTIs causing more aggravation we recently decided to end the seroquel and begin risperdal

She has been on risperdal 2x a day for 2 1/2 weeks and is calmer (if you've read my other more lighthearted posts then you'll know that I often refer to her warrior Viking ancestors when her behavior is ramping up) but still has her little Viking moments

She takes BP and diabetes meds and I know these anti-psych meds increase her risks and she seems to be gaining weight but for the present moment risperdal seems to be a better choice for her than seroquel
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Katie, at some point in our elder's lives, it starts to be " lesser of two evils". My mom is on meds for depression and agitation that in a younger person, might be contraindicated for someone with chf, pulmonary edema, etc. The agitation is causing her immediate psychic pain. I will always vote for and allow meds to cure that symptom, even if it hastens her demise.
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COPD and congestive heart failure co,boned with all the drugs he takes for these conditions is really a No-no for wine (or anything stronger)
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That generation relied on good whisky to calm down. How about a sip of his favorite bourbon in a glass of soda? Scotch and a cigar? A little red wine? Just a little, not a lot.
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Gabapentin is prescribed for seizures and a side effect is sedation. It is also prescribed for neurologic pain.
Zoloft does take about two weeks to become effective. You don't get high on it ut it smoothes out the mood much the same as Prozac.
Haldol, Respiridal and Seroquil are all anti psychotics. If you are just looking for something to ease anxiety Ativan and Valium are good for this but sedating. Ativan is the go to drug in hospice and care needs to be taken titrating it up in the very elderly. failing this Seroquil may be tried and if it works fine but it may have the opposite effect but you will find that out very fast.
Before turning to drugs make sure there are no collateral problems like constipation, pain or urinary retention. Also be sure a UTI is not in the picture as this is often a source of great agitation. All medications need to be prescribed with care in the elderly because the body processes them more slowly and they have greater effect. For example a 30 year old may need a narcotic for pain but a 90 year old may get relief with Tylenol. Pain and agitation management can be very difficult so the Hospice way of prescribing a range of doses for the nurse to use works well because she does not need to wait for a new Dr's order before giving more. Unfortunately this rarely happens in the hospital setting which is why someone needs to be around to advocate for the patient.
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I took gabapentin for pain - didn't work and didn't notice any change in my moods - which wasn't an issue anyhow. My mom was very agitated - understatement - and was helped by both Ativan and seroquel. She also took haldol at one point but she only had very minor CHF. Ativan can be a bit of a problem with your loved one if they are a fall risk - which my mom was - but the benefit outweighed the risk.
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I took gabapentin for a long time, for nerve pain. Worked great. I don't know about it as a mood stabilizer.

Haldol is absolutely out for anyone with Parkinson's or Lewy Body. My husband carried a card saying he was never to be given it. His geriatrician thought it should be banned from emergency rooms and there were better alternatives today.

Has anyone talked to you about Seroquel?
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