My mother (see the Doppelganger thread in the Alzheimer's category) is now taking her meds. There are dosage and potency issues. Any advice?

Dougie; You said that you thought she might have taken an extra pill. How would she have gotten hold of an extra pill?

Dougie; Did two different doctors prescribe the two diff. meds?

Sundowning, at least for my mom, was really never about what time of day it was. We just noticed that she was different in the early evening when my SIL visited after work. She would insist that she had a terrible communicable disease, etc. When I would call her in the AM, nothing was wrong.

No your meds are fine. I imagine the mood was your mom just adjusting to finally having some needed meds in her system. Oh boy, no one could get my mom to take her meds! Then she’d take too many, she’d always hide them and I never did get them all together to work out a schedule for her. That’s just one reason she’s in AL now.

Hmm, did she explain why she took 2 last night, and 1 this morning, not all 3 at night together as the doctor prescribed?

I think since she can't reliably follow instructions like this, you have to give her the correct number of tablets, hand her some water and watch her swallow them. The poor lady seems to be too prone to confusion to be trusted to take her meds correctly, consistently. 

I do hope you realize Mirtazapine is supposed to be taken shortly before bedtime. If your mother likes to read when she climbs into bed then she should take it when she climbs into bed, not earlier. I will presume she was put on 7.5 mg as an intro dosage, as the doctor will increase after eight weeks of usage. Please tell the doctor she has resisted taking the drug up until now.

In reference to Cipro and Bactrim you need to make certain she has 6 8oz glasses of water a day at a minimum, as Bactrim can cause kidney stones or renal impairment which will make your mother loopy. Flush her kidneys well as she can get dehydrated.

My Mom got real loopy and Sundowners after her UTI Drugs, very common!

Dougie, please make sure that your mom does not have access to these meds other than the prescribed dosages.

It's very important that you tell the psychiatrist that she only started taking them in midMarch, not when prescribed in October. The second med you mentioned is the generic version of Seroquel which is an atypical antipsychotic. It can be a miracle drug for some folks with depression.

I must point out that she had been to the psychiatrist twice after he prescribed the medications, without her having taken them; and to at least two appointments with her own doctor, who also urged her to; and also a visit to the ER in a hospital when she had a strange crying episode ("I wanna die...") and they ran a series of tests on her, including an MRI, resulting in the "unspecified dementia" diagnosis. The ER doctor also urged me to get her to take the medication. When the urine test indicated a urinary tract infection and her doctor issued a prescription for it, I considered this the perfect lever to get her to take the other medications as well.

Situation out of the ordinary: My Mom usually takes the pills, as mentioned above, sometime shortly after dinner, because she retires for the night so early. Last night she went to bed very early and did not take the pills at all. I left them on a Kleenex in the bathroom as a reminder, knowing she gets up at odd hours to use the bathroom. This morning she had not touched them; but after I got up she approached me, where I was sitting near the water cooler, with the pills and an empty glass. I got the message. I filled the glass with water; she took the pills and drank some water. Better late than never, I suppose.

Since that last item she has apparently continued to take the pills with no problem. Last night, when she was going through an episode of apparent "Capgras delusion"--waiting for my "clone" to return--I gave her a glass of water and the pills. She accepted the glass of water; swallowed the pills without batting an eye; then took a drink of the water. Apparently whatever disdain she had for the medication she has no longer.

Update: The psychiatrist has written a new prescription, with directions for my mother to take THREE Quietapine tablets--same potency--per night. I set them out for her last night; she took two last night, and one this morning; all as I was watching. (Her sister said I should watch to see that she IS taking the meds; I have never had any reason to believe that she has disposed of them any other way.)