It was the only one that worked to calm my mother down.  She
eventually went off that when the Depakote took full effect, but
it takes 6 weeks to 3 months to build a therapeutic level and
Risperdol works in a few days.

Remember, you should be consulting with a geriatric psychiatrist
when you do this, since the effects can be so variable and there
are many drugs that you need to taper off of.  They usually give
something else with risperdol to prevent the muscle spasms known
as tardive dyskenesia.

Don't be afraid to *try* something new, but be prepared to work
with the docs to change if it doesn't work.

Beverly, while I would never suggest that Risperdal is no big deal, it
is not a particularly dangerous drug - it actually has fewer side
effects than many of the alternatives. They even use it in children
(i.e. for autism and other mental health disorders).

Mary G.

Hi Beverly,

Ativan is not an antipsychotic, it's a "minor tranquilizer" in the same drug
class as Valium. Seroquel is a "major tranquilizer."

"Major tranquilizers," antipsychotics, or neuroleptics treat funny thinking
(departure from reality) and the agitation it brings with it.
(http://www.websters-online-dictionary.org/definition/english/An/Antipsychot
ic.html) A side effect of these medications is that they make the patient
sleepy. They are not "habit forming."

Ativan is a "minor tranquilizer," in the same class as other anxiolytics
such as Valium (http://www.benzo.org.uk/ncti.htm). These medications in the
benzodiazepine family calm anxiety and relax muscle tension. They are "habit
forming" in the sense that one might need a larger and larger dose to have
the same effect and their long term use can be difficult to stop abruptly.
It takes a while to become dependent on these medications so for
intermittent or short term use there is no danger. These medications also
make the patient sleepy and they are often used to treat short-term sleep
problems.

HI Beverly,

Ativan (lorazepam) is similar to Valium (diazepam); both act as mild
tranquilizers.  Seroquel is an atypical neuroleptic (so-called
antipsychotics) that was introduced in 1997.  Risperdal (Risperidone)
and Zyprexa (Olanzapine) were introduced in 1994 and 1996
respectively.  Both Zyprexa and Seroquel have fewer side-effects when
compared to Risperdal; however, Seroquel may be more sedating than
Zyprexa.  Did that make sense?  

Please elaborate on "opposite effect".

What was the dose of Seroquel?  

Did the effect noted above start with Namenda?  

Take care,
Darryl.

Beverly,

Unfortunately, until I can run over to my Mom's house and look at the
Risperdol bottle, I can only be partially helpful.

The Risperdol comes in both liquid and pill form.  I know that Evelyn Ruut's
MIL is taking the pill form, but we asked the doctor for a prescription for
the liquid form, because one of the nurse's aides who is taking care of my
mother had experience with the liquid and found it convenient to slip into a
drink to get the patient to take it.

I will need to check the strength of the liquid medication.  However, the
(correct) dosage for us to start her on was one-fourth of a milliliter at
bedtime (the liquid comes with a dropper that is marked off with dosages).
We were to keep Mom at that dosage for a week, then up it to one-half a
milliliter, remain at that dosage for a week, then up it to one milliliter
if needed.  After about 2 weeks, the one-fourth milliliter dosage was no
longer enough, so we upped it to one-half milliliter.

The doctor said that we could also give a dose during the day if needed, but
we and the caregivers have decided not to.  Since the major problem was
sleeping and that has improved greatly, we just have the aides give Mom the
medicine before bedtime.  Enough of the effect carries over to the day time
that the worst of the anxiety is gone.

We did not try any of the other anti-psychotics first because we had heard
about Risperdol and specifically asked for that.  About 6 months ago, we did
try Doxepin (I think this is an anti-depressant) at a very low dose (10 mg
at bedtime), but this did not have any effect helping my mother sleep
better, and then my mother decided she was not going to take it anyway (she
is much more compliant now about taking her medicine).

You asked about the pre-Risperdol experience.  I am trying to reconstruct,
based on the doctor's notes and my memory.  My mother saw the doctor in late
Oct. 2003, which was when we got the Memantine prescription.  She did not
begin taking it immediately, because I had to order it from overseas and it
took me a while to find a place to order it from, etc.  So she started
taking it in perhaps late November.  The same week that she started taking
the Memantine, she became very agitated, not sleeping, trying to get out of
the house, etc.  I still do not know whether this was cause-and-effect, or
just a coincidence that a new behavioral stage in her Alzheimers started at
the same time as the Memantine.  At this time, she was not taking Aricept
(which she had taken up until mid-October when she quit taking all her
meds).

In January 2004, we had finally had enough of the agitation, so we took her
to the doctor again.  We got a prescription for Risperdol, put her back on
the Aricept, and discontinued the Memantine.  After the initial bump getting
the wrong dosage on the Risperdol, she seemed very happy for a couple of
weeks.  It seemed as if trading the Memantine in for the Aricept made an
improvement.

After reading in the chat group that the best results seem to be gotten with
Aricept and Memantine together (and also hearing that some drugs need 3
months to show a real benefit vs the 6-7 weeks she was on Memantine), we
decided to try the Memantine again.

This time, we did not notice an increase in agitation.  However, she was
also on Aricept and Risperdol, which was not the case the first time around
with the Memantine.

Unfortunately, my mother has entered a stage where she is declining rapidly,
even from one week to the next.  Things such as the agitation that seemed
initially to look like it was triggered by Memantine, now looks like one
stage in an increasingly rapid slide downward.  Sometimes I feel that there
are just so many questions I don't know the answer to.  You try so hard to
do the right thing for your loved one, but since this is a disease no one
recovers from, many of those "right things" feel fruitless in the end.

One thing that is a comfort regarding the Risperdol:  If you try it and find
out it is not for your mother (bad reaction, or whatever), be assured that
it does pass out of the body with time.  When we gave my Mom the overdose
(several days in a row) that turned her into a zombie, that effect
eventually wore off after we stopped the overdose.

Hope this info helps, Beverly.

-Jennie