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Antipsychotics for Dementia Patients With Extremely Severe Symptoms

Alzheimer’s disease is often accompanied by serious problems such as psychosis, delusions, mania, extreme irritability and aggressiveness, just to name a few. The first step in dealing with these is to get a thorough medical evaluation to be sure that other health issues are not causing or contributing to the problem. The next course of action is usually trying non-pharmacological approaches to the problem.

But if those approaches don’t work, you may want to consult your loved one’s physician about trying an antipsychotic medication. Despite their potential effectiveness, though, these drugs can have very serious side effects. Especially an increased risk of mortality in older adults with dementia.

But the Alzheimer’s Association states that their use may be appropriate for individuals with severe symptoms or who have the potential to harm themselves or others. The Association also says that in some cases the risks of the symptoms may be worse than those of the medication.

If used, antipsychotics should be prescribed in the lowest dose possible for the shortest period of time. This is the key advice that can prevent the horrors that are experienced by some Alzheimer’s patients taking antipsychotics.

When Ed was put on both an antidepressant and an antipsychotic he changed from being depressed, agitated, and having hallucinations and delusions to being one of the most contented, calm and lovable people you’d ever want to meet.

For patients with the most severe symptoms it basically comes down to this: Would you rather have your loved one continue living with agitation, psychosis, mania or other extreme conditions or would you rather try to afford your loved one a better quality of life despite the risk that their life may be shortened?

A daunting decision.

Has anyone out there had a loved one who was put on antipsychotics? Were the results positive or negative? Would you do it again? Why or why not?

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8 Responses to “Antipsychotics for Dementia Patients With Extremely Severe Symptoms”

  1. Debbie from Cininnati says:

    I tried an antidepressant with my husband and it worked out well.

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  2. Arnold Smith from New York State says:

    I’m going to do some research into to this and think about it some more.

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  3. John Patterson from chicago says:

    No way ever would I put my dad on an antipsychotic drug. those things are lethal. I’m surprised you even wrote about this topic.

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  4. Debbie from Toronto says:

    I’m with John. NO WAY.

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  5. Jason Martin from San Francisco says:

    We’re going to start my father on one of these drugs soon. Your post gives me hope that it may help. He has severe hallucinations about things that terrify him to no end. Like being shot in the head and things like that. I can’t stand to see him suffering like that so we’re going to the last resort – Zyprexa. Please wish him well. Thanks

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  6. Diana R from Shawnee Mission, ks says:

    Fortunately my mother is not having symptoms severe enough to consider one of these drugs, and I hope she never does.

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  7. Teresa Thompson from Lincoln, NE says:

    My husband had to be put on anti-psychotics 12 years ago after having a traumatic brain injury. He’s 67 now and experiencing more dementia, due to his age.

    Your article was helpful, because I have worried over the years about all the harmful side effects of these meds, but I know we could not have taken care of him at home without them. And besides, he is much more at peace with himself when he’s on them.

    Sometimes the severity of the behaviors could be benefited with drugs. We are seeing a psychiatrist who specializes in geriatrics. That would be my recommendation, if you can. And also to be sure and have periodic blood work done to check for problems with those side effects.

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  8. Jim says:

    “these drugs can have very serious side effects. Especially an increased risk of mortality in older adults with dementia”

    I read the above then I read some of the comments from people who say they would not use them on their love ones.

    1. If you are a full time in person caregiver you will give anything to control the unmanageable behaviors of an out of control AD person. In the world of AD, drugs can be your best friend.

    2. AD is a 100% terminal disease. AD kills 100% of its victims. There are NO survivors.
    If a drug ‘increases mortality’ all it means is that death might come a little sooner. Their suffering might end a little sooner. Because they are better behaved your suffering (as a caregiver) would end a little sooner.
    Please tell me what is wrong with that?

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