Any good meds to stop anxiety?

CapeCodMermaid, RN · Mar 11, 2005

We hardly ever use Ativan on our Alzheimer's patients....seems to either make them worse or they get snowed. Is it all anxiety or could there be a component of pain? Latest study I read stated that most dementia patients aren't getting nearly enough pain medication because they can't verbalize the pain....how about trying a Tylenol or 2 ...if you keep under 3000mg/24 hours she'd be ok.

FutureNrse · Mar 12, 2005

We hardly ever use Ativan on our Alzheimer's patients....seems to either make them worse or they get snowed. Is it all anxiety or could there be a component of pain? Latest study I read stated that most dementia patients aren't getting nearly enough pain medication because they can't verbalize the pain....how about trying a Tylenol or 2 ...if you keep under 3000mg/24 hours she'd be ok.

You could be right about pain being an issue. Elderly people don't always report pain to begin with, but in some cases they might confuse pain with anxiety if they aren't verbalizing well. Finding the cause of her anxiety before treating it is a good idea.

If the anxiety is related to her diminishing mental status, maybe trying a little reminiscence therapy might help. Just make sure you know what you're doing or you could cause more anxiety. For example, don't ask a specific question, such as "Do you remember your 21st birthday?", instead, ask a more general question, such as " what was the best birthday gift you ever received?".

It can be comforting to remember the past, especially when memory has become an issue, but it can be troubling if a direct question is asked, but cannot be answered. So keep it simple and build on her answers. If she mentions a certain gift, ask her to tell you about it, prod her memory a little to see if she can link it to other details, such as her age at the time, where she lived, etc. Take it wherever she wants it to go. Bring it up the next day, and keep reminders gentle so she doesn't feel like she's being grilled, or that it's a big deal if she forgot you were even discussing it the day before.

I've seen this used in LTC settings with great results. I interned at a LTC facility for a short period of time and loved working with the elderly. Also, as a child we cared for several relatives in our home, and found that talking to them about anything and everything is the best medicine.

Good luck, and keep us posted on her progress.

Blackcat99 · Mar 12, 2005

Thanks all. :) Maybe meds are not the answer. She doesn't complain of pain but I quess I could give her a little Tylenol. I was just now thinking that maybe I should take her to mental health counseling. Perhaps talking about her childhood abuse with a trained counselor may be helpful.

CAG12345 · Mar 13, 2005

Thanks all for your great suggestions! Ativan,clonazepam,namanda,zanax. I think aprazolam and zanax are the same
med? Mom is taking exelon for alzheimers. What kind of results have you been seeing with namanda the new alzheimers drug? Mom goes to adult day care twice a week. I've tried to get her to go 3 times a week but she refuses to go more than twice. I've encouraged Mom to be a more "positive thinker" but no luck. She was physically abused by her father and she talks about that a lot. I would love to take my Mom out more often but she prefers to stay home. I will take this med list to her doctor next week. Thanks :)

In addition to the other meds mentioned, Buspar, which is non-addictive like the benzodiapepenes Ativan/Lorazepam, Xanax/Alprazolam, Klonopin/Clonazepam, can be (useful as they are), is helpful in reducing "generalized anxiety." It is often recommended as a med that should be taken regularly, but I've seen it work as a prn as well. It doesn't make a person feel "high" or dramatically relaxed/sedated, rather works more subtley to reduce anxiety. Also, for longer-term anxiety, rather than going with benzodiazepenes, some of the SSRI antidepressants, such as Prozac, Paxil, Zoloft, etc. are excellent for reducing anxiety and are prescribed for anxiety even in the absence of depression, although often both are present and it's hard to tell what came first. Naturally, her doctor will know what's best.

I also agree that even if your mother is not interested in attending day care more than 2x/wk that other forms of social support/stimulation, such as a meal out with you, or a quiet interest/hobby at home, could be a distraction and offer some pleasure to her to distract from the anxiety and the bad memories which are now probably easily triggered by her Alzheimer's related dysfunction. Your mom is lucky to have such a concerned daughter who also has the skill of a nurse.

happy&healthy · Mar 16, 2005

Thanks all. :) Maybe meds are not the answer. She doesn't complain of pain but I quess I could give her a little Tylenol. I was just now thinking that maybe I should take her to mental health counseling. Perhaps talking about her childhood abuse with a trained counselor may be helpful.

Hi Cat again,

re " Perhaps talking about her childhood abuse with a trained counselor may be helpful."

What you shared of your mom's suffering, there are a couple of particularly successful methods available.

Find a counselor skilled in "Time-line therapy". You can get a basic idea about this, reading the paperback "Time Line Therapy and the Basis of Personality" by Tad James, & Wyatt Woodsmall.

Not only will such a counselor be able to dis-connect negative emotional charges from whatever abuse and guide healing, he/she will also help your dear mom adopt any positive emotional states she wants to feel moment-to-moment, as well as cross-contextualize them in future situations.

And another beautiful thing about this methodology is how quickly she can enjoy these changes.

Why waste extended periods in "talking/advicing", when happiness can be readily realized, & kept :)

I wish both of you all the Best :Melody:

Blackcat99 · Mar 16, 2005

Thanks Cheerfulsong. I've never heard of time-line therapy. I will certainly check into it. It sure sounds like it would be helpful for Mom!