Psychotropic Meds and Alzheimer's Disease

Recently I met with the Medical Director of Mom's Hospice group. Mom continues to deteriorate and we discussed this decline and the level of her psychotropic or mind altering medications. We had first used the Alzheimer's meds and then added a med which seems to help with her "disordered thinking." Before these two types of meds were ordered, she called out, "help" much of the time and seemed "tormented." After the meds she was much more able to carry on a conversation and be content. As she has declined, however, we wondered if perhaps less medication would be appropriate. We decreased the dose about 10 days ago and now she seems less settled, less at peace. We will return her meds to the original level.

Now it would be easy to look at this decrease as a "mistake", but it is important to remember that a bit of trial and error in med levels is necessary when dealing with the disease. As the person with Alzheimer's Disease declines, their brain is shrinking, actually dying. This deterioration may also dictate we decrease their psychotropic meds as what their brain needed 9-12 months ago may not be what is needed now. If we never try to decrease the meds we will never know if a lower dosage may be the appropriate. It may seem like trial and error and in fact it is. There is no absolute blue print for the med level in this disease. We always do want to have the lowest level of meds possible which also gives a quality of life to our loved one. The process is not easy, it is not clean and neat. It is a necessary balancing act. Only one more difficult, but necessary struggle in the tough fight against this awful disease.

May God hold you in the palm of her hand.