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Hello everyone, hope you are well. While mom was in rehab for physical therapy, I had a geropsych doctor see her. He changed her meds around because he thought she was to drowsy. He stopped her Alprazolam and put her on Buspar, decreased her Depakote once a day at night and decreased her Citalopram. The only problem is he kept her on Temezapam which is making her drowsy during the day. So as of last night I'm done with that... I'm not giving her Restoril. She is still to drowsy in the am and won't get out of bed, so I just kept her on her pain pills. Could she be having withdrawls from the Alprazolam? She is mean, angry and noncompliant ( more than usual)... I know the Temezepam is a benzodiazepines also and I think it's to much with the Buspar 5 mg three times a day. Has anyone ever been through this med switch? She's driving me crazy... and the drive is a short trip.

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I've seen many folks come in walking to mom's memory care and after awhile a lot are put into wheelchairs
Since I know about 90% are on antipsychotic drugs
I don't believe it is just the progression of the disease
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Get her off the Depakote, it is used as a chemical constrain unless she is bipolar or has seizures. My mother who has Alzheimer's disease was put on it and it causes muscle weakness, instability and lot of side affects. She was unable to talk or walk on it and when they took her off they noticed increased mental ability. Now she started to talk again. The nurses at the nursing home tried to tell me it was a progression of the disease, but it turned out to the Depakote causing her slow down in ability.
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So, the Beers list is great, but it is decidedly NOT a list of "never prescribe these drugs to someone over 65".

My mother suffered from severe anxiety with MCI and later dementia. Only a thoughtfully prescribed cocktail of SSRI, SNRI and anaxiolytic was able to keep her non agitated.

I told her docs that I would find it as unacceptable to find her agitated and weeping as I would to find her doped up, but that if there HAD to be a choice, she'd be sleepy and not agitated.

In dementia, in eldercare, it's usually a matter of the least bad choice.
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Way too many meds. Get her off the Depakote, it is a chemical constraint and my mom lost her ability to talk and walk on it. She has Alzheimer's disease and they kept saying it was a progression of the disease, but it causes muscle weakness and instability. As soon as they took her off they noticed increased mental ability.
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The BEERS list is maintained and updated by the American Geriatric Association. It lists what medications are safe for use in patients over the age of 65 and at what dosage. It also lists drugs that the AGA advises against using. Also listed are effects of selected drug combinations. We need to be getting the list out to practitioners.
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Talk to her Nurse, Doctor about what's going on and tell them again the meds she is on is not working, explain to them what is going on. We had the same issues with my mom and finally they adjusted her meds accordingly. When she progressed to different stages meds are being changed accordingly, For example mom no longer knows us, So why is she taking meds for her memory, etc. After my dad talked to them, they took her off certain ones.
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No one has mention weight. If she is small she may be getting to much meds. My dad is a 951/2 young Vet. And I have been caring for him almost two years. He sleep good through night and slept all day too. I called his heart doctor and he told me to cut his Quetiapine in half because it is to strong for him. His weight was 120 pounds. So this could be one of the problems..
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Just remember: Anytime there are opiods involved....Get a printout (from the pharmacy) at least every three months..keeping close eye on meds with street value...how often they are being ordered.and how many are ordered..compared to what your family member takes..and if there is a question....request a copy of the medication records of that family member..AND...when a doctor discontinues one of those opiods,...request in writing a copy of the destruction of those pills from the pharmacy or the facility....You may be surprised what goes on....and you will be wiser..
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Hello Ohmeowzer

I just tried to write and then I think my reply was lost so here goes again. I have had the same problem with Opioid drugs for pain and all the other medications sent my mother into a Dementia patient talking absolute nonsense and being really agressive, confused and a totally different person - only to be told its dementia - right!

Use anything you can from Alternative. My mother was on 8 Paracetamol during day and pain worse at night and trying all sorts of horrible drugs. My breakthrough was finding a Homeopath - the right one. She made me up a pain mix ( I was a little dubious if it would work) my goodness it was instant no more pain medication.
Plus I also used an Acupuncturist to help as well.

My mother gets allergies and I used Piriton antihistamine the side effect is it makes you drowsy so that helped at one point. I would use Valerian tincture 10ml to promote relaxation and sleep (Valerian is a natural tranquillizer) Sedative herbal teas.

There is a TENS machine to look into
But use the Natural Therapies
You need to get her off those drugs as soon as you can
I saw there is a BEERS List created by some Doctors to list drugs that SHOULD NOT be given to elderly - Temazapam is on there
There are more elderly dying of the drugs given than the complaints they go in with
Get a Qi Gong Master to see her
There is Reiki - and Pranic Healing too as well as just plain spiritual healing
Pain can relate to guilt
There are a lot of levels to healing explore them all and do not get caught into the mainstream is the only way it is not.
My mothers condition was made massively worse through the management and the rediculous overuse of powerful Morphine etc luckily I have knowledge of other ways but it was a desperate time to start until I found the right people
Good luck and God bless you and your mum
Love Paula
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I agree with Glad you need to speak with her physician. Another option might be a visit with a medication manager. I have multiple health issues and take several medications. I see a medication manager approved by my health insurance twice a year or if new meds are added. She is a Physician's Assistant and has taken numerous pharmacology classes. She runs all of my prescriptions through a computer program for adverse reactions and side effects. She goes over each med with me and goes over any issues I'm having. She's on staff at my primary care doctor's office.

In getting my PhD in Clinical Psychology I had 3 required pharmacology classes required. I took two at Harvard Medical School and one at University of North Carolina School of Medicine. I can't prescribe anything, but needed the classes to do therapy with drug addictions or to understand how a medication might be acting on a person's psyche. There were medical students in those classes.
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All meds in benzo category must be weaned off. (Main reason is severe depression and suicide ideation occurs.) Usually takes four to five weeks to wean off any benzo. Many meds are on list that are not for elderly and to fill them you have to have doc tell pharmacy. ...even then many insurances will not pay. Any med changes will cause reactions. Talk to pharmacy if you cant talk to doc. And do research at reliable sites. Usually a doc will give you pcs for weaning off. Like half one dose in morning for week. Then half at night for week. And so on. They do half of half...so it really takes four to five weeks to completely get off them. Many drugs cause dementia to worsen and cause short term memory loss. With any drugs you would have to measure side effects vs. results. I worked in a medical institute but I am not doctor or nurse. So, please check with them. Your pcp for mom will prolly say to go back to drugs used before hospital stay if new drugs not working. Best wishes and hugs x
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I had the same experience as Hugemom. My mother became tired and it would take me an hour of working with her to get out of bed. She was hostile and angry, even hitting. It was all due to a urinary tract infection which can be pretty common in older folks. Have this checked.

Also I am in agreement with others that a pharmacist is the expert on medications. Check with your pharmacist regarding side effects, counter indications etc.
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Pharmacists have to go to school for 6 years to become certified to dispense medication. Most medical students do not have to take any pharmaceuticals classes. If they serve an internship under a doctor who knows a lot about medication issues, they have a leg up. But pharmacists are really the experts about drugs and drug interactions.

As a general rule of thumb, the American Geriatric Society advises that no person over the age of 65 be prescribed more than three central nervous system drugs at the same time. It should be noted that the FDA has issued warnings about the use of anti-psychotic meds in the geriatric population. Haldol is the anti-psychotic most closely linked to stroke and death in patients with dementia; Seroquel comes in at Number 2. If you can find one, your best bet might be to find a geriatric psychiatrist. They are, unfortunately, a rare breed.
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It's great that you had the geropsych workup, but do you have confidence in this MD? Is he/she accessible to you, responsive? If not, I'd find another doc who is. I would not fool around with taking anyone, especially an elder, off any of those meds suddenly...maybe if you have a good pharmacist they could advise you better...
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What I do before ever taking a new medication is to first find out if it causes drowsiness. If so, I only take it at bedtime. Meanwhile, remember to tell your doctor about the medication side effects on your next visit
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You really need to talk to her dr. The elderly react very differently to med changes...and stopping a benzo cold turkey is miserable for anyone.

Please contact her dr ASAP, in the meantime, talk to her pharmacist. They are very well versed in the drug interractions...seriously, IMHO, more so than the drs.
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Talk with her doctor first explaining how your mom is.
Ask if any of those pills should have been tapered to reduce side effects.
Talk to a pharmacist about the issues
Ask to have a review of your mom's medications with a pharmacist.
Amazing how some doctors don't taper because they haven't been on that pill "that long" well, that sure has backfired on someone I know.
You can look up the meds online and read the interactions, whether it can be crushed or not and whether it needs to be tapered and educate yourself a bit on this too.
Good Luck! Oh.....Ask the Pharmacist....to review the meds.....doctors too busy....
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Just a suggestion, but when my mom contracted a raging UTI, she became very lethargic, combative and delusional. Has your mom been tested?
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well my mom takes 1/2 a pill in the morning & 1/2 at night of alprazolam so for the whole day she takes 1 pill then in the night i give her namzarac =not spelled right then at night she gets 50mgs of seroquel but they call it back to its name of quientine so if you can give her medicine that makes her sleep at night need to do that ..but when the sundown effect is going & needs to calm her down than you do not have a choice ..a tip try to give the medicine a hour before she would be a mr.hyde if has a sundown turn around ..my mom threatens to throw me out of the house ..or if she gets mean you will have to give her those meds at the time you need them sometimes .it helpto know what they do & how they help ...
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Polypharmacy is a big problem in the elderly. I agree with not stopping suddenly any medication. Some medications need to be tapered off gradually especially SSRI's and Benzodiazepines.
On a side note to another poster here...my dad takes Buspar and it is NOT worthless for him. It reduces his anxiety without the side effects of a benzodiazepine on the brain
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I agree with gladimhere.
You need to be discussing these medicines with her doctor. Be her advocate there. Because none of us here have examined her or have access to her medical records and are most likely not doctors.
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Before you discontinue a med check with her doctor. Tell doc that she is too sleepy and let doc determine the appropriate adjustment.
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This is one of the most delicate treatment changes for any aging person, as well as any person for that matter... Each individual absorbs multiple medications at different rates, & this becomes much more difficult with age... the doctor has to find the right combination for your Mom. She may or may not be metabolizing the combinations at the right rate... This is a very-very "tight rope" course of treatment, & as with ANY medication, not everyone responds the same way to the same combinations and/or doses. Sharing your concerns and the details of how/when/ and if the medication is given with the doctor helps. There is always the choice of a second opinion, but whether going through that process all over again is a bigger question ... This one of those moments of testing your patience to the ultimate limits... Many prayers to you.
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For what it's worth, my mom briefly stopped taking it, at her doctor's direction, and she felt awful so he put her back on. She had been taking it for months before that.
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Could be that she is reacting to not having the Alprazolam. How long was your mom on it before the doctor stopped it?
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Can she take the Temezapam at night? Buspar doesn't do much, pretty worthless.
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