My 81-year-old father with dementia lives in a LTC facility, and in February 2022, was put on NAMENDA, LEXAPRO, and DEPAKOTE. Two weeks in, he had terrible side effects (more confusion, agitation, and even some hallucinations). Psych lowered the dose on NAMENDA and LEXAPRO (and kept DEPAKOTE the same 125mg 3x a day). It’s been a month and confusion is still there. He’s also agitated, and very very antsy. Psych suggested increasing DEPAKOTE to 250 2x/day and leaving LEXAPRO and NAMENDA as is. I have a feeling that one (or all) of these drugs could be causing this new behavior. All I know is he wasn’t this bad before he started. I’m going crazy because all everyone says is it’s the dementia. It could be that - but it’s got to be the drugs, too. Anyone else's LOs have side effects on any of these?
I believe it could be the Namenda - it is known to cause agitation and hallucinations (psychosis), because it is an "activating" agent.
In Geriatrics, "Less is More." I would respectfully ask the psych team to decrease the dose until discontinuation - they will know what to do.
And, please, please...do NOT stop this medication and any others "cold turkey" and without the oversight of medical doctors. Doing it incorrectly can cause more harm - primarily causing a rebound agitative state, increased anxiety, etc.
The team is using the depakote to calm him down. 250 mg twice daily is an appropriate dose, but I would watch him closely for increased sedation - we don't want him falling and hurting himself.
The lexapro is one of 2 "go-to" antidepressants that has good evidence in older adults.
It is a fine balance - we never want to overmedicate our loved ones, but we also need to make sure they are treated appropriately and not suffering.
Hope this helps!
I would add:
If they gave these drugs against dementia, stop it. If they gave it to keep him quiet, stop it. If they gave it, because he had psychosis, that’s a bit more tricky. Sometimes drugs can help the mind return to reality (stop psychosis). But sometimes the same drugs that are supposed to stop the psychosis, make the psychosis worse.
If OP you have the final word, ask them to slowly stop these drugs down to zero. You can see how your father is without these drugs.
Not suddenly zero. That creates backlash. Slowly decreasing. Then you can see if he’s better off without it.
Was he going through a psychosis before the drugs? Sometimes psychosis goes away on its own (without drugs). Sometimes psychosis lasts a long time. Sometimes psychosis is indeed caused by drugs.