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My mother gets anxious around dinner or thereafter. It seems that as evening is approaching or upon, us she becomes anxiety ridden, argumentative and hard to deal with period. I took her to a general practice doctor today for a follow up visit after hospitalization for Arrhythmia and told them I needed medication for her bloating after eating and anxiety in the evenings and asked if they were familiar with 'Sundowning" and they said they were.

They prescribed Prilosec for the bloating and when my sister brought home the medications the one they prescribed for anxiety was Ativan. I have personally taken Ativan before and half of one pill knocks me out cold in about 15 minutes so I cannot see that this medication could ever be the correct one for her anxiety. I do not want her groggy or chance her falling when she gets up at night to use the bathroom.

Can you all share with me the types or names of medications you have found to be helpful for anxiety/sundowning and with the fewest side effects please.

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Try milk for dinner. It has a calming effect and if that doesn't work, try 1 tablespoon honey, 1 tablespoon apple cider vinegar mix together and drink quickly. She will sleep, not be drugged and be able to go to the bathroom without falling. Whenever you have a choice for reacting to a behavior of a person with dementia, first try non-pharmaceuticals. Also, get mom plenty of exercise during the day so she will be more tired at night and won't want to be awake. Exercise (walking) costs nothing and is so beneficial. Try those suggestions and let us know how they work. Best wishes!
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We had very good experience with my AD 93 year old MIL by keeping bright lights on until bedtime and giving her 10mg of Melatonin (OTC) with no side effects. However, everyone is an individual and there may be other underlying problems that a normal GP visit can't cover. I'd suggest finding a good Endocrinologist and have a thorough chemical workup/evaluation.
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I also tried melatonin but the Neurologist said never give more than 6mg to an elderly person. We ended up on Depakote Sprinkles after a year of not slepeing, and it was a life saver to us. My Mom tried to get out the doors and windows, it was awful but after a year, it ended and she became mellow again, as she is now. Ask the Dr and see what he says. I have taken Ativan to go on 2 plane rides and it never made me sleep but it did my Mom so much her face fell into her plate, Try a 1/4, then 1/2, as long as the pharmacist says you can cut it. I only get pills you can crush, no extended release of time release meds. Good Luck and dont try and reason with her, agree with everything she says! She will forget it anyway.
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Finding the correct psychotropic medicine is less a function of the particular anxiety and what time of day it occurs than it is a function of your mom's body chemistry. Your Ativan example makes the same point: it knocks you out but it doesn't knock everyone out. Your idea to research common reactions is a good one, and you can do a lot of that online besides asking this forum. But don't assume that everyone's body chemistry is the same, and do expect that you might have to go through a couple of different dosages or even a couple of different medicines before you find the right thing for your mom. Enlist your doctor's help in what is essentially a trial-and-error collaboration.
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Look into Buspar. It is an anxiolitic (anti-anxiety) rather than an antidepressant or a tranquilizer. Also, it isn't an anticholinergic, which is really important.
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Ativan is very, very scary to me...I know we can all react in different ways to any medication, but I can tell you that Ativan was an absolute nightmare for my family in regards to my Mother...she had a 'resolved TIA' according to the ER doctor, but she had been given Ativan to ease her anxiety when she was refusing to have a catheter inserted (they hurt like crazy in the elderly)...unfortunately, the Ativan did a complete number on my Mom...she went into a semi-coma from which she never recovered and she died one week to the day later. The consensus is that Ativan should never be given to an elderly patient with dementia. This also happened to an aunt of mine, so this wasn't just a question of wondering if Ativan had a negative effect, it clearly did. It's entirely possible your Mom will tolerate it just fine, but I find it very scary and wouldn't feel right not to at least tell you what happened in my own family and possibly prevent the same thing from happening to you. You can check out other people's comments by googling 'Ativan and the elderly' to see what I'm talking about. Best of luck to you!
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We had some success with tiny amounts of Xanax for my 92 year old MIL in the last eighteen months of her life when she had a very hard time with sundowning and general anxiety. She had always been whats often referred to as "high strung", but she went off the charts with this after her husband died and her dementia deepened. She was a very petite woman and we had to calibrate whatever medication she was given very carefully. Also, just let her set most of her agenda and pace of life for the last year. We were there to accommodate her. She didn't take much medication, and we tried to keep it minimal, but when Namenda was added to the regimen, that seemed to help a lot with the behaviors, helped calm and settle her, and she seemed less confused. The addition of most of these medications needs to be titrated carefully, and takes about 30 days to reach full effect. I wish I had known then about the depakote sprinkles. I've read a lot about them since her passing and think those might have helped more than xanax. I have heard mostly bad things about ativan. It's important to remember, too, that what merely sedates younger people can severely suppress respiratory activity, or lead to further confusion and falls in the elderly. I cannot stress enough the importance of being very watchful and closely monitoring the use of pharmaceuticals in the elderly, especially the frail very old.
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My mother has been prescribed .5 mg Ativan pill by her Pulmonologist to help her get to sleep at night due to her having COPD. He told her to also take one when she became anxious during the day. What a nightmare. Her whole personality changed and she almost killed us driving while under the influence of this medication, unbeknown to me. I researched the use of Ativan and warned her about the side effects and dangers of this medication. Now she only takes it at night prior to going to sleep. She seems fine with this regiment. Her care primary physician is also aware of her on this medication. Should I be concerned with the long term effects of this medication?
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With older folks it is VERY tricky... I think trying to use distraction finding something she is interested in... Birds and Blooms magazines have wonderful pictures...also County magazine. Medication can be just be hard, Buspar, Risperdol and Xanax are the common ones... Be very careful, take care, Jaleyn
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You might want to look into Clonazepam (Klonopin). The normal dosage is 0.5 mg. However, the pills can be cut in half for a 0.25 mg dosage. I've had 2 home care clients use this medication effectively for night-time anxiety with little side effects. One of my clients uses it during the day as well when she feels anxious.
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