My mom has now been in the NH since January. She was put under hospice care recently. She has really never been sweet,but she has recently become downright hard to get along with. Thinks people steal from her, tries to kill her as of now 2 of the housekeepers are not allowed in her room and she gets furious when she sees them in the hallway. They increased her ativan and are putting her on depakote. I still go see her Monday - Friday. I am now taking xanax .05 before I go in. Any thoughts on depakote...what I have read on the www is kind of scary. She is not going to give up easily...and she had started hiding her ativan so the nursing staff have to see her take it now. She is having to take morphine for her chest pain because nitro doesn't work anymore. She is either in her wheelchair or bed.she can use her walker to go to the bathroom right now. She still gets out some but is so paranoid it isn't pleasant.
The way I like to look at it is if you're dealing with life or death, raging infection, immediate anxiety or panic, suicidal ideations, etc., certainly the first thought must be medicine to the rescue.
For less serious situations, learn to try homeopathy, herbal tinctures, flower essences, nutraceuticals, nutritionals and dietary changes.
According to the medical profession, the problem in doing these integrative, complementary or alternative actions or procedures is that it delays what might end up being needed medical treatment.
This problem or conflict is only going to be solved when the first responders, doctors, EMTs, nurse practitioners, physician assistants and nurses are fully train in a comprehensive way to look at persons as a whole and assess their needs which will require those people either learning the other modalities or having other professionals on staff who do.
Just my $0.02 as a prescriber and taker of medications myself!
About the misuse of antipsychotic drugs , we can find a very interesting article (that I'm sure that you read it before0 searching in Google for the title :
" Why is Big Pharma getting away with paying billions in criminal fines – but avoiding criminal charges?"
But only the physician of the patient can decide in each case that the patient ,maybe have to takes very small doses of some antypsychotic drug to protect herself and others from threatening behaviors.
Best regards
caarllos
I pasted bellow the text with the corrections ,and with additional information .
CORRECTED :
Thank you Ferris to reinforce all my advises to do not gives NONE medicine drug or none supplement without the prescription and permission of the physician of the patient .
I guess that you did NOT NOTICED ,about how much times I carefully advised to none person to do NOT gives NONE drug or supplement without the physician prescription.
Please , read what I wrote again , and you will see that I made exaustives and lots of advises about to do NOT gives NONE medicine drug and NONE food supplement without the physician prescription ,supervision and advises.
Once more you made a mistake in your comment : when you in a very malicious way , you made a misjudgment, and wrote that I made a “trial test case” with my aunt. Nothing more so far from the truth, that your unfortunatelly words about that.
I did not made that , and I only gave nutritional supplements that you can find in the market,and that the american F.D.A. ,consider acetyl L carnitine, ( a component of meat) ,L–carnosine (another component of meat), glucuronolactone (the natural substance that you can find in the form it derivative , the glucaric acid in large amounts in apples, broccoli ,oranges,etc), glucosamin sulphate (extracted from crustaceans),and the food extra virgin coconut oil.
Glucuronolactone, for example , you can find in large amounts in the form of glucaric acid in broccoli apples ,etc.
In one apple (the fruit) of 170 grams we can find aprox. 695 MILIGRAMS of glucuronolactone in the form of glucaric acid.
If you consider that we use to gives to my aunt the nutraceutical supplement called glucuronolactone in the doses of 300 miligrams four times a day ,it means that she takes the dose of glucuronolactone equivalent to only TWO apples of 170 grams by day.(as you know , each apple contains aprox. 695 miligrams of glucuronolactone in the form of glucaric acid).
But you as me and all the mamalians , have lots of glucuronolactone and glucaric acid in our bodies , because glucuronolactone and glucaric acid (the derivative of glucuronolactone metabolization) it is produced from our bodies from the carbs that we eat ,and GLUCARIC ACID is so important to life that if the liver do not gets or produces every hour enough glucaric acid , it can produces liver failure ( as a nurse , you know that glucaric acid is an urinary biomarker of liver health).
It is obvious that healthy persons do not needs to takes none supplements with glucuronolactone or glucaric acid , if they have health livers and brains ,
But it is a option to doctors in some cases of high peroxynitrite accumulation , as in dementia patients , to gives some nutritional supplements with glucuronolactone. (But ONLY the physician of the patient can prescribe it.)
Only for your information, my aunt in 2009 , after some episodes of deep psychotic behavior of my aunt, her children was decided to put her in a hospice , because none caregiver or relative could deal anymore with her absolutely mad behavior, once she used to break the windows of her house, used to stay yelling all the night ,without sleep even with xanax and other restrain drugs ,used to gives strong punchs in the caregivers and relatives,did not eat the meals , used to walk in the room of the house during four to six hours without stops and did not want none help, to say that she was NOT in her home and tried to scape all the time ,.
She was very agressive,agitated ,with hallucinations and with delusions that the caregiver was stealing from her, and she began to try to hit the caregiver with brooms, chairs, etc.
The caregiver had to hide all the knives, forks, sharp and perforating instruments of the the house , because she trheatened to use that instruments against the caregiver, etc.
But one Day , in 2009 , before she started to takes that NUTRITIONAL supplements , she chased and hit (bang) the caregiver with one broom, and then the caregiver escaped and locked her own self in a bedroom to protect her self against the chase and hits of my aunt, and then my aunt went to dinner room and she broke all the windows of the dinner room with the broom.
After that episode, her children decided to put her in a hospice .
But 20 days before to put her in the hospice, we gave a very small dose of the NUTRITIONAL supplement called glucuronolactone (dose of 300 miligrams 4 to 5 times a day,and as I described before everything change for better . (but as I thoroughly wrote again and again ONLY the physician of the patient can prescribes or gives permission and advises to use medicine drug OR nutritional supplement. As I wrote ten times in the texts in this site, please , talk to the physician of the patient ).
Now we are in 2013, and as in 2009 , after she started to takes that NUTRITIONAL supplements she is calm, easy to cope, smiling , understanding what people talks to her , without yells, without cryings ,without hallucinations , without delusions, without delusions ,without NONE agressiviness or agitation and without to go to NONE hospice , she is in her own home. Without to asks that she “wants to go home” (as she used to do before the nutritional supplements) once now , she knows vewry well that she is in her own home.
Please read again carefully what I wrote a LOT OF TIMES that ONLY THE PHYSICIAN can prescribes and gives permission to use ANY drug or nutritional supplements.
I understand your concerns , but I guess that you did NOT noticed to my advises in the texts that I wrote before ,about my anedoctal report of the empirical and well succesful use that nutritional supplements.
I pasted bellow , all the advises that I put in the others texts ,. That looks that you did not noticed before :
FIRST ADVISE “... But only the doctor can prescribes and give the right advises to the treatment of the patient...”
SECOND ADVISE “... Then we changed of doctor and he told to us to starts with only ONE DROP ONCE A DAY of risperidone]...”]
THIRD ADVISE “ ... Including friends of mine that ARE PHYSICIANS nd that have relatives with dementia ,started to gives that "combo" of supplements and observed the same very good results. And they (the physicians) gives risperidone (in that very small doses) only if the patient is very agressive, agitated with strong delusions and hallucinations...” ( AS YOU CAN SEE THEY ARE PHYSICIANS ,THEN THEY CAN DO IT).
FOURTH ADVISE“... But this is only an anedoctal report without NONE scientific foundation , about the absolute empirical use of that supplements...”.
FIFTH ADVISE “... The responsability for the use of that supplements descrbed above , is in the hands of who takes or gives it to the patients.lease talk to the doctor of the patient before, and only use it under prescription, supervision and advises of the physician of the patient...”
SEVENTH ADVISE ‘... Please , consult the physician of the patient and do NOT stopds none medicine drug prescribed by the physician and do not starts the supplements above without his permission...”
EIGHTH ADVISE “... But please: Talk to the physician of the patient, because only his physician knows what the patient can or not takes...”
Kind regards
Carlos
Frankly, if nutritional supplements and the right diet are really all you need, more power to you. I use a combo myself for my own issues. Some supplements I was tried on made me as ill and miserable as any drug side effects I ever had, but as whole, they are less dangerous most of the time. And you can go into PubMed and find quite a few articles about many of the things that are commonly tried - you'd be surprised what supplements have good evidence of efficacy and are now almost mainstream for migraine, for example.
I encourage you to do your own research and not dismiss anything out of hand. Doctors and nurses hardly know everything. New things are being discovered all the time. The important thing of course is patient safety so always keep that in mind.
I guess that you did NOT payed attention fo how much times I carefully advised to none persoon to gives none drug or supplement withlut the physician prescription.
Please , read what I wrote again and you see that I made exausfive and sucessive advises about that.
Pnce more yli made mistake in your comment .when you amry and malicious wrote that I made a trial test case woth my aunt.
I did not and I only gave nutritio al supplements that you can find in the market.
Only for your information, her dmilh in 2009 at yhe month that sje started to take that supplements , before the supplements works, juet kn that week , i 2009 ,they was to put her in a hospice , because none caregiver or relative could deal with her absolutely mad behavior, braking windons of her house,givong punchs in caregivers and relatives, yelling all the night.
NNow we are in 2013,and she is calm, easy to cope,smiling , undersganding what people talks to her , without yells, cryings ,hallucinations , delusions, and kn her own home.
Please read again carefully what I wrote a LOT OF TIMES that ONLY THE PHYSICIAN can prescribes and gives permission to use ANY drug or nutritional supplements.
I jneeestand your concerns , but I guess that you did NOT payed attention to my advises i my anedoctal report of the empirical use with that supplements
Kind regards
Carlos
I guess that you did NOT payed attention fo how much times I carefully advised to none persoon to gives none drug or supplement withlut the physician prescription.
Please , read what I wrote again and you see that I made exausfive and sucessive advises about that.
Pnce more yli made mistake in your comment .when you amry and malicious wrote that I made a trial test case woth my aunt.
I did not and I only gave nutritio al supplements that you can find in the market.
Only for your information, her dmilh in 2009 at yhe month that sje started to take that supplements , before the supplements works, juet kn that week , i 2009 ,they was to put her in a hospice , because none caregiver or relative could deal with her absolutely mad behavior, braking windons of her house,givong punchs in caregivers and relatives, yelling all the night.
NNow we are in 2013,and she is calm, easy to cope,smiling , undersganding what people talks to her , without yells, cryings ,hallucinations , delusions, and kn her own home.
Please read again carefully what I wrote a LOT OF TIMES that ONLY THE PHYSICIAN can prescribes and gives permission to use ANY drug or nutritional supplements.
I jneeestand your concerns , but I guess that you did NOT payed attention to my advises i my anedoctal report of the empirical use with that supplements
Kind regards
Carlos
I'm sorry but maybe i can not help to much with doctors and I will explain why:
1) As I wrote above, I started to use that supplements with my aunt , trying by my self , and I have to say , without consult any doctor (please , do not do it) , once as I read a lot about that supplements , during a long time , and as I got as much information as I could in the google and mainly in the site Pubmed , and others scientific medical sites,and as that supplements are OTC drugs or natural supplements, and as her physicians did not believe that none natural supplement could enhance or improve anything in a disease that Alzheimer's associations and Alzheimer's researchers says around the world that" there are no treatments" , and telling you the truth,none doctor support the use of that supplements.
Then , one day , that my aunt was in one very deep psychotic behavior, crying all the time , yelling , very agressive (giving punchs in the caregiver), agitated, with delusions , hallucinations, without sleep at night and nor too during the day , without eat ,etc. , we gave a beverage that contains 300 miligrams of the supplement GLUCURONOLACTONE .
Exactly one hour after that she took that 300 miligrams with the food supplement Glucuronolactone, she started to be very calm , stopped to cry and to yel , started to smile and talk friendly, gave a hug in the caregiver that she gave Then we started to gives that beverage punch two hours before to takes the glucuronolactone, and started to cope , and to have a very good mood , and improved her cognition, and stoped the hallucinations.
Unbelievable ?
Yes , I tought the same !
Then we started to gives the 300 miligrams of glucuronolactone three to
four times a day, and we observed that if we gives that 3 to 4 times a dy (some times 5 times a day) , we kept (as we keeps until now) her very good behavior, mood, improved cognition, etc.
But we observed that when she took some fat meal or some medicine drug as painkillers, it impairs the good effects of glucuronolactone to improve cognition ,mood and behavior, once glucuronolactone is used by the body to detoxification , and when the body have to detoxificate from fats and some medicine drugs , the body uses the natural substance glucuron olactone to detoxification. (our bodies made our own glucuronolactonne from the food that we eat),
Then we lowered her ingestion of fats and we observed that it enhanced the good effects of glucuronolactone.
But during almost 3 years since we started to gives the glucuronolactone, none physician could believe that the natural substance glucuronolactone could be working like that.
We started to gives the glucuronolactone in 2009 , and during this time since 2009 , I started to read about others supplements , that I tried in an absolute empiric and NON scientific way , and at last, I observed that the best combo that worked in a synergistic way with glucuronolactone , to improve cognition, mood and to control agressiviness, delusions, hallucinations, etc,was that combination of glucuronolactone (the super) , the acetyl L carnitine,the L-carnosine, the exra virgin coconut oil , and the glucosamin sulphate,
But all without NONE , medical or physician support , but only by my own decision, and careful empiric observation about what was working in the lowest doses .
Then I started to tell to friends of mine that have relatives with dementia about how that supplements was working to im prove cognition , mood and behavior of my aunt , and they started to gives the same supplements in the same doses to their relatives with different types and stages of dementias, and they started to observe significative improvements, obviously , according the deeply of the each stage of dementia.
Some of that friends of mine that have elatives with dementia are medicine doctors, physicians, and they could not believe in my reports , what I found absolutely natural , once if someone told me the same , I could not believe too.
Then I used a strategy to convince my friends that are physicians.
I sent by email ,scientific articles about glucuronolactone, acetyl L carnitine, L carnosine,and after some weeks , I gave to then , some small bottles with the powder of glucuronolactone, powder of acetyl L carnitine , etc, and I made a suggestion to that physicians friends of mine :
What about to gives that small doses of that supplements to their relatives with dementia by 15 days, and to observe what happened (using including medical scales of mood and behavior ads the NPI-Q scale,etc), and after that 15 days , they could tell me what they observed of improvements (or not ) of cognition, mood and behavior of their relatives with dementia?
In 48 hours, all the physicians that tried the supplements call me and said in the phone : Buddy , what is that? The "mad" and "odd" behavior stopped in less than 24 hours after they started the supplements !
I told they (joking ) : nothing new to me. I see it all the time.
But some things have to be clear : the good results in mood and behavior are not continuos and are not stable, once we are using very 'primitive' natural supplements and not medicine drugs.
But the relief to caregivers is tremendous!
They start to have a dementia patient very easy to cope, that is more calm, without delusions, hallucinations, without agitation,etc.
But all that I described above it is about the absolute empirical use of that supplements and that medicine doctors , do not want to gives to patients , but only to their relatives that they are more confortable to control it.
But I guesss that medicine doctors that works with orthomolecular medicine , maybe will accept to gives that supplements in that very small doses.
My suggestion is to do NOT gives during the first month of use, other supplements than the glucuronolactone, L-carnosine, acetyl L carnitine, and extra virgin coconut oil , to the relative or caregiver observe what works.
Well , the other reason that I'm sorry because I can not help you more than with this anedoctal report, is because I live so far from you, once I'm from Rio de Janeiro, Brazil , but even if you could come to Brazil , I have to tell you that I do not no none doctor that use that supplements to treat dementia ,once most around the worls, still believes that "there are no treatment to AD and other dementias"..
But please: Talk to the physician of the patient, because only his physician knows what the patient can or not takes.
Best regards
Carlos
Thank you for the information...warrants some research on everyone's part.
You gave an important advice:
Risperidone can not be used for patients with Parkinson disease , but only for patients with Alzheimer disease and other dementias that do not have strong motor impairments.
For Parkinson disease the indicated is seroquel.
But what I observed with my aunt that have vascular dementia and Alzheimer disease ,is that seroquel did not worked to control her delusions agressiviness and hallucinations , even in higher doses, but risperidone in that small doses did the job very well.
But each patient is different from the other. Then only the physician of the patient can find the right drug , with the help of the reports of caregivers and relatives of the patient.
Only to correct what I wrote : the dose is of 0.1 miligram to each drop of risperidone.
. When my aunt was having that behaviors of high agressiviness , delusions, agitation, saying that someone steal, one neurologist gave depakote associated to xanax and it do not worked as is not working to my aunt too.She took seroquel too and it not worked again.
Then we changed of doctor and he told to us to starts with only ONE DROP ONCE A DAY of risperidone at morning during ten days, and then , each ten days we should increase to twwo drops at morning.
Then if with two drops of only 0.1 miligram did not works well , he told to gives too one drop of 0.1 miligram at night , up to two drops of 0.1 miligram at morning and two drops of 0.1 miligrams at night , but always monitoring blood pressure 4 times a day , and advising that if blood pressure falls , we should stops for one day and starts in the next day with half dose of the day before.
And it worked very well to lowers the episodes of delusions, agitation, agressivinesss,, inmsonia,etc., with only two drops of 0.1 miligrams at morning.
But things really starts to works , when together with that 2 drops of 0.1 miligram of risperidone once a day at morning, we started to gives some natural supplements that we can find dozens of scientific articles in the scientific site Pubmed :
L-carnosine : We started to gives the small dose of 60 (sixty) miligrams at breakfast at lunch and at dinner, and we observed that she started to be with a "relaxed face" and much more calm.
L-carnosine is safe and works in that small dose , and is a peroxybitrite scavenger, a heavy metal chelator ,an antioxidant and a antiglycating substance, that are some important propierties to treat dementias.
Acetyl L carnitine - We started giving the small dose of thirty miligams four times a day by 20 days and then increased to another small dose of 60 miligrams 4 times a day (but not at night) , and we observed that she ioroived her speech ,gait, attention, strehgh,etc.
Acetyl L carnitine (it is NOT carnitine , but acetyl L carnitine) is a peroxynitrite scavenger and heavy metal chelator too,r enhances mirtochondrial and energy function of the brain, and there are too dozens of articles about acetyl L carnitine (the so called ALCAR) in the medical site PubMed , about research with ALCAR in Alzheimer and other neurodegenerative diseases.
Extra Virgin Coconut Oil - as dr. Mary Newport says, this extra virgin oil works very well as an alternative fuel and mitochon drial enhancer to the brain , and we observed that it oil improve the attention, mood and speech of my aunt.We gives very small doses of only ONE TEA SPOON at meals , two to three times a day.
Glucuronolactone : it is a natural substance found in apples and broccoli as glucaric acid , and is a liver detoxyfier, a mitochondrial improver,a peroxynitrite scavenger,an alternative fuel to the brain too. Glucuronolactone in small doses of 200 miligrams to 300 miligrams 3 to 4 times a day realyy changed the world to my aunt , and gives great improvings in cognition , mood and mainly in the control of delusions, hallucinations, agressiviness, agitation.
Glucosamin sulphate : Yes , that joint supplement works too as a peroxynitrite scavenger and as an alternative fuel to the neurons , glucosamin sulphate during a week that we did not find to purchase the glucuronolactone and glucosamin sulphate was not amazing as glucuronolactone, but helped a lot in the control of her "mad" behavior (and after a coulpe months can improve the joint condition too), We use doses of 200 miligrams 3 to 4 times a day .
After I started to use the "combo " of small doses of risperidone and of the supplements above, we started to have our aunt "back to life" again , once she stopped or lowered the episodes of odd behaviors, she started to eat all the meals, to sleep all the night, she stoped with cryings , yels, agression, she is calm , started to smile again, to look in the eyes of persons that talk to her, to take and asks for baths,, she started to be very easy to cope.
Then I started to tell to my friends that have relatives with different types and different stages of dementias, and they , under the permission and supervision of the physicians of the dementia patients,started to gives the same supplements and the same doses to their relatives and they got the same amazing results that we are having with my aunt.
Icnluding friends of mine that are physicians and that have releatives with dementia ,started to gives that "combo" of supplements and observed the same very good results.
And they gives risperidone only if the patient is very agressive, agitated with strong delusions and hallucinations.
To the other patients that have different stages of demen tia , but do NOT have a psychotic behavior, they gives only that supplements and they as we , are seeing a partial reverse , delay and control of dementia symptons.
But this is only an anedoctal report without NONE scientific foundation , about the absolute empirical use of that supplements.
The responsability for the use of that supplements descrbed above , is in the hands of who takes or gives it to the patients.
Please talk to the doctor of the patient before, and only use it under prescription, supervision and advises of the physician of the patient.
Only a note: patients that takes warfarin (coumarin) and/or aspirin (acetyl salycilic acid-A.S.A.) : that supplements can have a synergistic effects with anticoagulants and blood thinners, and for example , we had to lowers significativly the use of aspirin by my aunt. But only the doctor of the patient can do it. Please , consult the physician of the patient and do NOT stopds none medicine drug prescribed by the physician and do not starts the supplements above without his permission.
He was also on resperidone a couple of years ago with serious side effects. It reduce dopamine. PD patients already have a deficiency in dopamine. it literally put him on his back for a month after I researched it and stopped it with our PCP's agreement. It had been prescribed by another Psych. Needless to say we no longer see that Psych.
Haldol (haloperidol) it is NOT indicated once have strong side effects , making the patient a "robot" that can not walk by her self , and sometimes even can NOT seat by herself.
But very small doses of another antipsychotic , in very very small doses of only ONE OR TWO DROPS (each drop with 0.1 miligram and NOT ONE miligram, it means, a dose ten times smaller than the usual , that two drops once a day (up to two drops each 12 hours) , can stops the agressiviness, agitation, delusion,etc.
Antipsychotics in high doses can be very harmful and even kill the patient.
But risperidone with that smaller doses (01. and NOT 1 miligram) can helps a lot.
But we have to control the blood pressure of the patient 4 times a day. If the blood pressure starts to be lower than 120X80 , we have to lowers or to stops the very small doses of risperidone.
But only the doctor can prescribes and give the right advises to the treatment of the patient.
But I saw a high efficacy of that 2 drops once a day of risperidone to control agressiviness, delusions that someone steals , etc.
So, has your mom been on depakote for over three weeks now or did you order her to be on something else? The stuff looks like it has a particularly nasty array of side effects. As you already felt, not one to casually prescribe unless there's absolutely nothing else.
As missy writes, now that she's on hospice, there should be many other choices available, such as narcotics or tranquilizers without the fear of addiction