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Anyone have experience with Klonopin?
vaeagen
Posted: Friday, February 8, 2019 7:30 AM
Joined: 4/4/2016
Posts: 92


Hi  all,

My dmil (pwd, 84, stage 6 Alzheimers) is experiencing a lot of agitation and is getting very difficult to manage at home. She lives in her own house (only 2nd place she has every lives, for the past 61 years, which she does not recognize, of course) with my fil (86 yo, in very good health for 86 yo, fil still drives and cooks, etc) with a 24 hour live in aide. But she has been progressively been getting more and more, and MORE agitated and difficult to manage. Borderline violent. She is already on 200 mg/day or Seriqiul but that is not helping the symptoms. The Pysch that we just saw and her Neuro are adding the Klonopin and was just looking for any advise from the wise people here. Anything we should look for or possibly expect? As I said she has been very close a few times in the past week for going to the Geri pysch ward but would like to avoid that, if possible.

 

                    Valerie


ruthmendez
Posted: Friday, February 8, 2019 8:26 AM
Joined: 9/8/2017
Posts: 1765


Sorry, I don’t know anything about Klonopin, but is she taking anything else already? Something that can be discontinued? My father did not do well with mirtazapine and his psychiatrist discontinued it. He is on seroquel and .5 mg of Ativan. That seems to work for him. How long has she been getting progressively worse?
ruthmendez
Posted: Friday, February 8, 2019 8:30 AM
Joined: 9/8/2017
Posts: 1765


He was on 200 mg seroquel also,. Recently reduced it to 175. Bouts of anger returned but it’s manageable
vaeagen
Posted: Friday, February 8, 2019 10:07 AM
Joined: 4/4/2016
Posts: 92


My dmil has been on Seriquil since being hospitalized in July with agitation and suicidal talk. She started at 50 mg/2x a day but is now on 100mg/2x a day and it seems to not be having any effect. My dfil will give her another 25 mg as needed but again....it is not having a great effect. We finally got her to a psych but not one was really thrilled with him but he prescribed Klonapin 1 mg/3x a day. We gotta try something because what we have now is not sustainable....her behaviors can be extreamly difficult and she is soooo upset.

 

                           Valerie


jfkoc
Posted: Friday, February 8, 2019 10:08 AM
Joined: 12/4/2011
Posts: 16189


My husband's Dr had a very strong negative view about this drug. There is quite a bit written about it that you can read and make up your own mind.

Recent studies have showed that non-medical treatment can be as effective as drugs. There is a lot of educational information on line and at your library. Here is a list of books gathered from posts here. I suggest the Naomi Feil which is not meant to be scanned but read. 36 hour day is more of a book to refer to. All of these are someone's favorite.

The Alzheimer's Action Plan.  Dr Doraiswamy's


36 Hour Day


I'm Still Here: A New Philosophy of Alzheimer's Care Paperback by John Zeisel

Creating Moments of Joy. Jolene Brackey

Dementia beyond drugs Allen Power

Dementia Beyond Disease: Enhancing Well Being. Dr. Allan Power'

The Validation Breakthrough. Naomi Feil

Thoughtful Dementia Care: Understanding the dementia experience. Jennifer Ghent-Fuller.

2002 edition is available online in pdf format for free.

Validation::The Feil Method. Naomi Feil

Dancing With Dementia. Christine Bryden

I'm Still Here. John Zeisel

No Act of Love is Ever Wasted: The Spirituality of Caring for Persons with Dementia  Richard Morgan/Jane Marie Thibault


Insider's Guide To Better Nursing Home Care: 75 Tips You Should Know by Donna M. Reed


An unintended Journey:  A Caregivers Guide To Dementia Janet Yagoda Shagam

Before I Forget.  B. Smith

Chicken Soup for the Soul:… Amy Newmark

I'm Still Alice Lisa Genova.

Kisses for Elizabeth: A common sense approach to Alzheimer’s and Dementia. Stephanie D Zeman MSN RN

Learning to Speak Alzheimer’s.  Robert Butler

Loving Someone Who Has Dementia.  Dr. Pauline Boss

On Pluto: Inside the Mind of Alzheimer’s. Greg O'Brien, Lisa Genova

Surviving Alzheimer’s: Practical tips and soul-saving wisdom for caregivers. Paula Spencer Scott

Taking Care of Aging Parents Who Didn't Take Care of You. Eleanor Cade

Ten Thousand Joys and Ten Thousand Sorrows: A Couple's Journey Through Alzheimer’s.  Olivia Ames Hoblitzelle

The Long Goodbye, by Reagan's daughter

Understand Alzheimer's: A First-Time Caregiver's Plan to Understand & Prepare for Alzheimer's & Dementia Calistoga Press


vaeagen
Posted: Friday, February 8, 2019 10:49 AM
Joined: 4/4/2016
Posts: 92


Jfkoc,

I appreciate all the readings and I agree that technique and approach has a lot to do with care but I feel that my dmil is past any of that making a big impact. She is screaming, I mean screaming when you just put a damp wash cloth to her skin! No amount of explaining, time, gentle, not gentle, works. She does not want to wash now, later, tomorrow or anything!! She thinks she has done or can do whatever needs to be done. She can't/hasn't done any care, cleaning, cooking, etc for a couple of years. She is soldidly in stage 6. Don't even get me started on wanting to GO HOME!! NOW!! or how cold it is in the house (it is 82 + degrees in the house and she has prickly heat rash from all the blankets she has piled on top of her). She gets so upset that she sometimes throws things because we won't take her back to her childhood home. She has not lived in her childhood home for over 61 years. She threatens to call the police and tell them that she is being held against her will.

 

I am not against behavioral technics but her behavior, I think is out of control for any of these technics to work. Just my .02 cents.

 

                  Valerie


ruthmendez
Posted: Friday, February 8, 2019 10:52 AM
Joined: 9/8/2017
Posts: 1765


I think a general health check, lab work and all can be checked to make sure nothing else is hurting her. My father’s valsartan/hcl was increased and the diuretic caused hyponatremia and he became violent. That was my mistake because I was checking his blood pressure and reporting it to the cardiologist and in errror his cardiologist increased his dosage. That medication was discontinued in ER. Later his cardiologist changed his medication and no longer prescribed the diuretic
egilbert
Posted: Friday, February 8, 2019 11:12 AM
Joined: 11/26/2018
Posts: 3


You will always hear different opinions on different drugs.  I do not have any experience with the drug for someone with Alzheimer's...but I do have my own personal experience with Klonapin.  There was a time where I experienced severe anxiety and depression.  I sought help with a psychiatrist.  I was prescribed Klonapin and Zoloft.  I know Klonapin is a very addicting drug but since I was being treated and frequently monitored, my dosage was always limited and I always knew that it was short term, only until I was well and stable.  I got better and with the help of my doctor, slowly tapered off of it and have been completely off of it for some time now.  I did not have any bad side effects.  It calmed me, I was less anxious, and felt like myself with it.  My mother also has anxiety and depression and has been taking Klonapin for years.  If my MIL who has Alzheimer's was prescribed it for out of control behavior, I would give it to her (my husband is her  POA and he knows it helped me, he would give it to her).
vaeagen
Posted: Friday, February 8, 2019 12:06 PM
Joined: 4/4/2016
Posts: 92


Thanks egilbert,

I understand that it is addictive but we all know that my dmil is terminally ill. If she needs it to make her comfortable then so be it. If she was a young woman I would be very concerned about addition but since my dmil is at the end of her life, that is nothing I am worried about. I am glad to hear that it helped you with anxiety. that is what we are trying to fight.

 

                       Valerie


jfkoc
Posted: Friday, February 8, 2019 12:28 PM
Joined: 12/4/2011
Posts: 16189


Valarie....I have been exactly where you are and the drug being discussed was haldol which is totally not recommended for LBD. I ended up letting them give it to him. It was the best choice even so. I would not be worried at all about it being addictive. The concern with PWD is that it is thought to cause memory problems. It is also sedating which can lead to falls. I would start small and titrate up.

It is hard when none of the choices are wonderful but you just have to help your mother. You just have to.

I hope you will keep us posted. Your experience will help us learn more about this drug and we care how both of you are doing.

Hang on!


YellowTulip
Posted: Friday, February 8, 2019 12:51 PM
Joined: 2/7/2019
Posts: 2


Hi Valerie,

I have been prescribed Klonopin for my anxiety.  It really helps when I have panic attacks. I am also on Seroquel.  I have found that the Seroquel helps with my racing thoughts and the Klonopin helps with my physical symptoms of anxiety like racing heart and restlessness.

Klonopin can make me feel a bit sleepy but it calms me down and centers me.

It really depends on how many mg are taken. I take 1mg tablets for my anxiety. If your LO is taking a higher dose you may see the lethargy and sleepiness.

Hope this helps a bit.

YellowTulip


vaeagen
Posted: Monday, February 11, 2019 8:03 AM
Joined: 4/4/2016
Posts: 92


Thank you everyone who took the time to comment. It is very hard to know what to do with my dmil and her behaviors. Unforntnately, on Friday I was not able to get the Klonopin Rx to be filled due to some "insurance approval" being needed. So we had to go the week end without starting it. Of course, over the week end my dmil behavior escalated to now actually hitting my dfil. It was not hard but still her behavior is moving in a bad direction. There are no behavioral methods we can use since she just can not be reasoned with in anyway. She simply "WANTS TO GO HOME! NOW!" or she is cold, or sweaty or repeat same over and over. Everyone in the house needs to go to bed or she needs to get washed up, etc.

 

Anyway, I hope that we can get the Klonapin on board today and then we can take things from there. The Pysch put her on 1 mg/ 3x a day. She has also been waking up with what I believe are night time Charlie horses in her calves. Of course, this is not helpful. I believe she has already been taking some Potassium to prevent this. Her Rx have been the same one she has had for years so I do not think these could be caused by a Rx. She also has had "phantom" pains before (complained of something in/on her back) but those have now disappeared, without treatment. When she was in the hospital with the flu that was checked out and nothing was found to cause her feeling there was "something there". Also she felt this in multiple places, bed, chair, hospital so it was not the "bedding".

 

If this does not work then I know that it would be only a matter of time before she will need an intake geri pysch.....I would like to avoid that if for no other reason than the distruption and distress it will cause everyone.

 

                 Valerie


i2i
Posted: Monday, February 11, 2019 8:20 AM
Joined: 8/12/2017
Posts: 144


Generally speaking, it is recommended to avoid benzodiazepines (the medication class of klonopin and ativan) for the elderly due to fall risk.  That being said, I know PWD who were miserable, and miserably difficult to care for due to confusion, paranoia, hitting, screaming throwing, etc., who only did well with the combination of an atypical (seroquel, risperdal) and a benzo.   Marvelously well.  So yes these meds should be avoided if at all possible, and used in conjunction with behavioral and environmental adaptations.  But IMO with careful introduction and proper monitoring they have their place.  1mg seems like a high starting dose though.  And be aware it is dangerous to stop them abruptly.
NC caregiver
Posted: Monday, February 11, 2019 8:24 AM
Joined: 2/7/2018
Posts: 745


I don't have any experience with these meds but want to wish you success in finding something to calm her.   Since she is having cramps you may want to encourage more fluids which I know from experience is hard to do . Dehydration will make issues so much worse.
cdolan70
Posted: Monday, February 11, 2019 2:01 PM
Joined: 4/1/2014
Posts: 20


My mom has been using Klonopin for the last two years with good results, especially at night before bed.  Just make sure you stay on top of the refills.  Last year, my mom ran out of Klonopin for a couple days while the pharmacy, doctor, and insurance were arguing, and she had a huge seizure from the withdrawal.  Now I always make sure I have a ton on hand
vaeagen
Posted: Monday, February 11, 2019 2:10 PM
Joined: 4/4/2016
Posts: 92


Thanks cdolan70,

Yes I am finding out all the problems with prescriptions and the insurance company. I have been "working" with 2 dr and the insurance company to get this approved. Right now I have to say that this is probably our last shot at keeping my dmil from a stint in geri psych. My dfil (86 yo and pretty well all considering) is trying to deal with dmil (with the help of a 24 hour live in aide) but with her being so "difficult" to manage this may be the last try before we have to take more drastic measures. When I saw her actually hitting my dfil (I watch everything or review difficult transition times on a "nanny cam") when they were trying to get her changed for bed (they have done this, obviously numerous times before....with resistance but no actual directed violence...before) I knew we were heading in the wrong direction. My dh (only child so it is all on us) and I live only about 5-10 mins away depending on traffic and weather. I am going to pick it up, hopefully on my way home from work and drop it off to them. I hope that it will help....otherwise I am not sure where this is all heading.....

 

                  Valerie


 
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