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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Lamdage22 on November 22, 2017, at 12:41:50
Hey dr-bob friends,
my grandma is in a very bad state of mind. The doctor says that many tranquilizers cant be taken by people with dementia.
Is this true?
Posted by Lamdage22 on November 22, 2017, at 12:44:48
In reply to Grandma developed severe dementia, posted by Lamdage22 on November 22, 2017, at 12:41:50
She is 98.. and until recently she was very resilient.
Posted by linkadge on November 22, 2017, at 15:11:04
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 22, 2017, at 12:44:48
Wow. That's a good old age.
Depending on the symptoms, sedatives may not be a good idea. They can cause disinhibition and can worsen cognition, mobility, balance etc.
For just anxiety, something like escitalopram might be worth trying. The AP's are also best avoided, if possible.
Linkadge
Posted by Christ_empowered on November 22, 2017, at 17:13:03
In reply to Re: Grandma developed severe dementia, posted by linkadge on November 22, 2017, at 15:11:04
i dont know if its in your country yet, but the fda just approved a non-neuroleptic drug for some forms of psychosis (parkinson's, I think...). I don't know how it works, honestly, but...yeah. I don't think it causes all the problems tranquilizers do, especially in the elderly.
sorry this is happening.
Posted by Lamdage22 on November 23, 2017, at 12:54:21
In reply to Re: Grandma developed severe dementia, posted by Christ_empowered on November 22, 2017, at 17:13:03
but then shed be kind of a lab rat.
Posted by rjlockhart37 on November 24, 2017, at 20:18:13
In reply to Grandma developed severe dementia, posted by Lamdage22 on November 22, 2017, at 12:41:50
98 is defeintly an achievement to live that long, thats very good, but since cannot really determine what drugs to use, only her doctor can, but honestly i think aricept and others, they can slightly imrove cognition, with memory loss and dementia but there not as effective, to bring it back, memantine is still a good choice, but to seriously improve it, you would have to use multiple medications, stimulants increase brain firing and sharpness, but you have to do certain brain exercises to bring it back. But when the brain gets to a point of slowness, and some deteriation because of age, there's not much you can do. I'm glad your grandma has lived to 98, that's .... pretty long time
Posted by Lamdage22 on November 25, 2017, at 6:03:11
In reply to Re: Grandma developed severe dementia, posted by rjlockhart37 on November 24, 2017, at 20:18:13
Thanks for the replies. Well i will not advocate the use of drugs. If her cognition improves a bit she will ask the same question 4 instead of five times. Given the propensity for side effects...
It came within a matter of months. I think she is past the stage were medication has a chance to work. Antidementiva are very controversial.
Posted by Lamdage22 on November 25, 2017, at 6:04:14
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 25, 2017, at 6:03:11
i dont know if i should visit. She may not know who i am anymore.
Posted by MightyKondrian on November 28, 2017, at 16:50:22
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 25, 2017, at 6:04:14
Yes, hard situation.
So they haven't tried Piracetam yet???
Prescription nootropic commonly used in Alzheimers. Its very non-toxic with few, if any side effects.https://examine.com/supplements/piracetam/
Thoughts go out...
MightyKondrian
Posted by SLS on November 28, 2017, at 19:17:29
In reply to Grandma developed severe dementia, posted by Lamdage22 on November 22, 2017, at 12:41:50
I'm sorry about your grandmother.
Statistically, people with Alzheimer's Dementia who are treated with neuroleptic antipsychotics die sooner. I don't think scientists know why yet.
A serotonin 5-HT2a receptor antagonist (or better yet, an inverse agonist) is thought to reduce pscychosis in Alzheimer's. I'm thinking maybe cyproheptadine (Periactin) would be helpful. It is not a neuroleptic antipsychotic. It tends to be sedating due to its antihistaminergic properties. This might be a desirable side effect. I believe that risperidone (Risperdal) is unique among APs in that it is an inverse agonist at 5-HT2a. Perhaps a low dosage can be sufficient to deal with agitation.
- Scott
Posted by Lamdage22 on November 29, 2017, at 6:35:54
In reply to Re: Grandma developed severe dementia » Lamdage22, posted by MightyKondrian on November 28, 2017, at 16:50:22
I dont think she has psychosis as of now. Does Piracetam make you calm?
Posted by MightyKondrian on November 29, 2017, at 12:00:25
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 29, 2017, at 6:35:54
> I dont think she has psychosis as of now. Does Piracetam make you calm?
>
>I'm not totally sure. It should definitely help with cognitive function. There are a whole host of racetams (race-ett-ams). If she could take Aniracetam that would help with depression/anxiety.
In my opinion anything that helps cognitive function would also help the dementia.Mildly stimulating and calming in one. As for the psychosis I cannot comment sorry.
Posted by SLS on November 29, 2017, at 13:24:48
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 29, 2017, at 6:35:54
> I dont think she has psychosis as of now. Does Piracetam make you calm?
>Neuroleptics are given to dementia patients for agitation rather than for psychosis.
- Scott
Posted by SLS on November 29, 2017, at 13:37:42
In reply to Re: Grandma developed severe dementia » Lamdage22, posted by MightyKondrian on November 29, 2017, at 12:00:25
What about pramiracetam for cognition?
I am confused as to what symptoms need to be addressed. Memory? Cognition? Behavioral? Agitation? What?
- Scott
Posted by baseball55 on November 29, 2017, at 17:42:54
In reply to Re: Grandma developed severe dementia, posted by SLS on November 29, 2017, at 13:37:42
> What about pramiracetam for cognition?
>As far as I know, having had relatives and relatives of friends develop dementia, there is no known treatment for cognitive deterioration. This is why many people don't want to be tested for genetic predisposition - what's the point? There's nothing that can be done anyway.
Me, the only reason I'd want an early diagnosis is so I could kill myself before I ruined my children's lives.
Posted by Lamdage22 on November 30, 2017, at 2:57:07
In reply to Re: Grandma developed severe dementia, posted by SLS on November 29, 2017, at 13:37:42
She is very demanding, she does not want to be alone...
I dont think that she is agitated as of now. I heard the same thing... That nothing can be done anyway.
Antidementiva are even more controversial than Antidepressants.
Posted by SLS on November 30, 2017, at 8:29:10
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 30, 2017, at 2:57:07
> She is very demanding, she does not want to be alone...
>
> I dont think that she is agitated as of now. I heard the same thing... That nothing can be done anyway.
>
> Antidementiva are even more controversial than Antidepressants.Well, we are still a few years away from a robustly effective Alzheimer's drug coming to market, although there are a few candidates that work to actually reduce amyloid plaques (aducanumab). They demonstrate an ability to improve cognition in rats bred to simulate dementia. In the meantime, I don't disagree with the use of a cholinesterase inhibitor with memantine.
It is unfortunate that there is still any controversy at all as to whether or not antidepressant are effective in treating certain mental illnesses. However, I would argue that many doctors do not use them properly.
- Scott
Posted by Lamdage22 on November 30, 2017, at 10:12:14
In reply to Re: Grandma developed severe dementia » Lamdage22, posted by SLS on November 30, 2017, at 8:29:10
Well like baseball hinted, it takes a toll on my mother and her sisters...
My Grandma does not want to go the hospital or nursing home. However it might happen that she has no choice.
If she was clear in her head, the last thing shed want is that her daughters suffer because of her. That is not her.
Posted by SLS on November 30, 2017, at 11:02:26
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 30, 2017, at 10:12:14
> Well like baseball hinted, it takes a toll on my mother and her sisters...
>
> My Grandma does not want to go the hospital or nursing home. However it might happen that she has no choice.
>
> If she was clear in her head, the last thing shed want is that her daughters suffer because of her. That is not her.
>Special woman...
- Scott
Posted by Lamdage22 on November 30, 2017, at 11:17:38
In reply to Re: Grandma developed severe dementia, posted by SLS on November 30, 2017, at 11:02:26
She was so soft and loving these last couple of years. Sometimes elderly are cute. They become like children in the positive and (later) the negative way.
Posted by Lamdage22 on November 30, 2017, at 14:15:42
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 30, 2017, at 11:17:38
I think i will visit anyway some time. I just need to prepare that a little bit with a therapist i think.
If i was old, i would want people to visit.
Posted by MightyKondrian on November 30, 2017, at 14:28:20
In reply to Re: Grandma developed severe dementia, posted by Lamdage22 on November 30, 2017, at 14:15:42
SARCOSINE
This is the end of the thread.
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