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I moved mom to ALF a month ago. She was not happy-- mean and moody. (She gets this way every time we have moved her.) The Nurse Practioner said Depakote worked great for this and would calm her too. But she seems to have bad days on it. Worse memory, dead stare, just out of it. I've read Depakote is not right for dementia. Anyone else have experience with it? She is also on Zoloft and tiny tiny dose of Klonopin which seemed ok in rehab to calm her.

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Glad I found this site. I can get into all the details but long story (somewhat) short...dad is 85. was actually working a part time job until about a year and a half ago. he and mom lived with each other and got by ok...could do the shopping, paid the bills, etc. Problem was mom said Dad was getting extremely angry and mad. according to her would yell and scream at her for everything and threaten her. he was also still driving and probably should not have been.

went to neurologist about 2 years ago and he scored very well on the tests...29 out of 30 on one of them so doc did not prescribe meds. about 18 months ago tried aricept but it made him more agitated according to mom. Neurologist then took him off everything. He continued to get agitated and his memory and ability to stay organized getting worse but he still managed. Since mom was afraid we thought they should try independent living facility and we did not let him take his car up there so he stopped driving. Two big changes at one time. he got more agitated and would wander at night so went back to nueroligist two weeks after they in independent living facility and he prescribed very low dose serequil - 12.5 mg in morning and 25 in pm. A week after that he had a blow up with one of their employees - not violent but screaming, cursing, arms flaling, etc. and they said he could not stay in independent facility. mom was still afraid of him so I lived with him at his home for two weeks while trying to find AL or Memory care unit for him.

During that time we would tell him doc said he couldnt drive his car and when he freaked out nurses told us just hide the keys, tell him something, etc. nothing worked and he became fixated on the car. actually called the garage to have the car towed to get keys made. during the two weeks I lived with him there were many periods where you would not know anything was wrong with him and then other times he would go crazy about the car and not being able to drive.

after 2 weeks of living with him tried to move him to AL that he had visited half a dozen times before moving in, and only lasted one night...he wanted to go home but did not want caregiver and kids could not watch him 24/7. He freaked out so bad - would not let people guide him back into assisted living facility, etc. that he ended up going to Geriatric Behavioral facility - psych ward.

That was a week ago and now he is like a zombie. Went from times of total normalcy to a zombie and mostly talks incoherent babble. This has only been a week. Started him on Zyprexa - 5 mg am and pm. I told them after 5 days how badly he us compared to what he usually is. on top of that he started to get a slight electrical issue with his heart so they just switched to depakote but that was only today. I am praying that there is not damage that can't be undone. and tremendously guilty for what has happened to him and how we handled him.

My big question is can alzheimers patients recover at least somewhat from when they get into that mode where they are incoherent? of is there already damage that can't be undone?
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I am so glad that I came across this post regarding Depakote. Just yesterday Dad's Geriatric Psychiatrist put him on it. 2 weeks ago he was put on Klonapin? for his severe anxiety. A dose at 9 AM abd then PRN. Last week I was there to visit on Sunday evening and he was awful. So anxious he was calling out to everyone. In the Activity Room at his NH, he had every patient around him upset, which in turn made him even more upset and anxious. They gave him Klonapin and an hour later he was just as bad. Monday morning I called the Psychiatrist. Now they increased it to every 6 hours. He would come in to see him on Friday. Yesterday, I was there at noon to make sure I saw him. Looked at Dad and nope, no more Klonapin. Now giving him Depakote, in a very small dose. We'll see how it works. He's been aggressive with the nurses and other patients. Fell out of bed last week and tore open his elbow. His skin is so thin that it tears easily. 3 areas are torn. It's bandaged and the nurse wanted to show me when she changed his bandage. He would have none of that. I guess when he went to sleep maybe she changed it.

Also...,the last 2 weeks I noticed his right eye closed. The NH says they think when he's anxious and does the pursed lip breathing and the hand tremors are worse on the right side,the eye closed. OK....yesterday he was not doing the pl breathing, but the eye was closed. I have a call into the eye doctor to see him. Could be his macular degeneration or my own opinion...a series of TIA's. Maybe even the muscle that controls the eyelid. At 97 and end stage Dementia, on pudding pureed foods and occasionally choking on them...all I ask for at this point is for him to be comfortable. Gosh....it's a hard road...this Dementia road...
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My husband has senile dementia--aggressive and extreme anxiety/agitation had to call police several times he attacked me. i have limited his meds---the geriatric psych and geriatric internist used depakote which was the ONLY thing that changed his behavior enough to make him docile, not a zombie, so i can keep him for now at home. he is a very difficult contrary person very controlling not a great husband---too bad he didnt have this drug 20 yrs ago he would have been a better husband! for me depakote is a life saver---he occasionally gets agitated to the point of scary but not nearly like before and he is not as depressed or dark as he was before taking depakote. he does have blood tests to check liver, etc...and the dose has to be modified now and again..we are at 500mg 3x a day per his doctors but have to re-evaluate as he had some behavior issues at daycare---i was given aricept (ICK-agitated him) risperidone (made him feel sick so quit after 3 days besides, its black box), trazadone which worried me combining w other stuff and didnt seem to do anything, exelon patch -horrid skin reaction----since there is no cure i refuse to put him on stuff that makes him feel bad. he tolerates depakote well and as long as i can keep adjusting w doctors as his behavior changes, i think it has given me a chance to care for him longer. neurologist said no benzos, so we have never used those; i stay away from risperidone, haldol seroquel etc..as depakote seems to be the answer for now. he also uses supplements and has a good diet.
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Why do you think she has copper toxicity? Has Wilson's Disease been ruled out by examining her eyes for the symptomatic rings? As Ferris says, copper toxicity is extremely rare.
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Iblack, just to remind you that you cannot just take her off of zoloft, you have to wean on and off of it. Many possible side effects going on and off, go slow. Watch for headaches especially, good luck! I give my Mom 3 teaspoons of miralax each morning and it works in 2.5 hours (doctor approved), and 4 oz of prune juice nightly. The klonopin will be discontinued when the zoloft kicks in probably, that can cause diareahea or constipation , and unsteadiness. It wonderful for stress.
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lblack5255 - Copper toxicity is extremely rare as the body does a great job of filtering out toxins and NOT absorbing certain ones. God doesn't make junk! I am so glad she is off Depakote and hope the Zoloft isn't making her too constipated.
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thank you all. I have taken her off depakote for now. It was not worth it to me. I don't want her to be overmedicated. I keep a tight watch on what they give her. She went from blood pressure pills only to now sodium, zoloft, klonopin, abuterol neb, O2 24-7, etc. So I'm trying to be a good advocate and looking things up. I also think mom has adrenal fatigue but no one knows how to treat in the gen med community. Someday it will be standard to understand when stress starts to affect your adrenals and treating will be known. Maybe because pharma drugs not the answer, supplements and diet are the keys. Copper toxicity is also an issue to watch for. I can tell she has this, but the doc thinks I am a nut job. Whadeva.
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My mom's doctor prescribed Depakote to treat her dementia-related agitation, and it turned into an absolute nightmare. Mom went through three weeks of abusive, psychotic rage by the time we weaned her off the Depakote and the drug finally left her system. But she has been permanently altered by this experience, and she was finally diagnosed with Lewy Body Dementia - a condition in which anti-psychotic drugs can have an opposite, and permanent effect. Please make sure your LO does not have LBD before assenting to treatment with such drugs, and if they do have LBD, please make sure they are watched VERY carefully for adverse reactions.
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First of all, this medicine when I was a nurse back in the 80's was used for people that experienced seizures, but I also heard it used for people who suffer with bi-polar, but you must be careful if the person has a heart condition. Of course since my back injury I had to give up nursing since 1986, but never heard of it being used for dementia or alzheimers. Also being on this other medicine you stated, sounds to me like she is being over medicated and I would question the doctor about this!!

My godmother, who I am POA for and I am her caregiver, is on a medicine for her anxiety. Three years ago, while we were still in living in PA and she was at a very so called "Exclusive Retirement Center", the best in our county they said, her doctor also prescribed Abilify to her. Within days she went completely off the wall!! I was away on vacation to see my daughter in upstate NY and was gone for a week, as normally I would visit my godmother 2-3 times a week. When I got back, she was so confused and disoriented, could not control her urine and was wetting herself and the bed constantly, was not eating. Not anyone of the nurses or aides did anything to help her, never called her doctor and as soon as I saw what was happening to her, I demanded to be given the fact sheet to this drug, and saw she was experiencing every side affect that was listed!!! I took her myself immediately to the ER, where she was admitted and was inpatient for 9 days!!! Her doctor was furious that no one from the Home had contacted her!!

Please, if your gut feeling and senses are telling you something is wrong, listen and contact her doctor ASAP or take her to the ER!!!! Sending my prayers to you!!
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Sorry but depakote is NOT an antipsychotic medicine. It is safe for children and adults that have seizures, also used to calm the brain with dementia/alz. My Mom was on it from ages 88-92. She is now 93 and out of that stage therefore doesnt need it any longer. Haldol is very bad and so is ativan,a neurologist is best to go to, my moms was the top neuro at the hospital who prescribed depakote. Dont worry about giving it, it was a lifesaver for my mom, everything is worth a try to help our parents.
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My mother had a geriatric doctor. I worked in geriatric medicine for 32 years. Depakote is not a med you would give to the elderly. Depakote has been around for a very long time. There is new and better medication. The medication depends on the patient's mobility. You send a child to a pediatrician. An adult to a regular PCP. The elderly to a geriatrician. Three different stages of life. All three different approach to medicine. Each know of Psychiatrists. My parents have passed. I took care of my mother for 12 years. I would never allow my mother to be given any antipsychotic medication. She was a sun downer. They told me to give her Haldol. She had an adverse reaction. I stopped it myself and gave my mother Ativan. I followed up with the Geritrician who agreed. Any medication that knocks someone out. There is a problem with staff or family to allow it continue.
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I found all your responses so helpful. The nurse insisted our doctor prescribe Risperdal, which I think is pretty strong and I have read can have very bad side effects (like all meds), but I'm not sure it is the best for early dementia. I am very interested to discuss the meds mentioned here with our doctor.
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My mom had a horrible reaction to Depakote! I remember that my mother's lethargy scared me. She too, was feisty, mean at imes, extremely agitated and at times aggresive. This drug subdued her to the point where she became almost rance-like and her neck began to hang.
Please beware of pschotropic drugs, the dosages and uses. Psychotropic drugs are not supposed to be used to control negative behavior. Many times, these drugs are prescribed for convenience.
I agree 100% with Ferris1. Finding a good geriatric psychiatrist who is willing to spend more than 5 minutes assessing your mom's reaction to the varying drugs and dosages. In addition, many times the general practiioner will prescribe a drug that will cause negative interactions when combined with psychotropic drugs. You may wonder how this could possibly occur. Well, the elderly are treated in pieces with one hand not necessarily knowing what the other hand is or has already done. I implore you to stay abreast of all medication changes, do your own homework, talk to pharmacists in your community, and read the Drug Interation Reference Guide. Above all, ask good questions over and over until you understand.
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Depakote is an antipsychotic drug and very dangerous one. It has a lot of side effects. I would never allow it to be given. Depakote is for people who have life long severe mental illness. If your mother is not mobile I would increase the Klonopin.
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Depakote is an anti-seizure drug, but used also in bipolar disorder. Having tried this once, I would not recommend it at all! Suggest trying Lithium in small doses if the NP thinks your mom is having mood swings. Try something that is an ion before giving a medication that is really going to change the way the brain reacts with many side effects. Lithium evens out moods, is non habit-forming and might help your mother, however, unless this NP is well-educated in mood disorders, I would get your mother to a geriatric psychiatrist to help. I've taken Lithium for over 40 years,get a dry mouth, have to check my kidney and thyroid functions, but it does the trick (for me). I just drink lots of water which is a good thing. Lithium is also the most studied, longest prescribed med for mood swings throughout the world. Simply the gold standard. It will also elevate depressive moods all-in-one, plus used for migraines. If one has a bad reaction to a drug, that is telling you not take it, but you decide.
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The most useful thing about asking an online chat forum for stories about experiences with drugs is that it reminds you how variable reactions can be. Don't take advice from it about what to do -- use it to inspire you to pay close attention and ask good questions.
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I don't see Depakote used as much for the alzheimers population as I used to. I see lots of Abilify and then sometimes a lorazepam to help calm folks down. Like everyone said, not really a "perfect pill for everyone.
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I have not experienced Depakote for use in treating dementia, but have seen it used for mood stabilization as a prior mental health therapist. Depakote can be very sedating when someone first starts it, as Reverseroles noted was her mother's experience. Since it calms the brain, as Reverseroles also noted, the staring and confusion can also happen when first started, until the brain adapts. Often this will wear off over time and/or a dose reduction. But, obviously not all medications are for all people.
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I guess we didn't give the Depakote a fair try; apparently it takes awhile to work up to a dose that fits. I hated the way mom was on it and felt she was not angry/out of control enough to keep her on it plus didn't care for the way we were treated by the snotty know-it-all nurse the neurologist had taking care of us. My solution was to ditch the neurologist for a gerontologist with the goal of getting mom off some of her meds. We did this and for now, at least, things are better. Not sure what the gerontologist when and if mom gets wild and crazy again and stays there, will just have to see. When she is extra hyper, I still have a ton of the mirtazapine. One of those will give her a decent night's sleep, and that works for both of us.
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Depakote was originally used for seizures, then when people began taking it, doctors saw that it also acted as a mood leveler for some patients.so they began prescribing it for mood problems. My son took it for seizures and it did have this effect on him which was a great side effect to experience.
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sorry for the type/o above, I meant unsteady on feet, not feed, haha. My friends mom was on 250mg 3 times a day, my Mom was on 125mg 3x a day, dont let them over medicate her. If she keeps sleeping a lot after about a month, ask to reduce it. I was so worried too, but relieved to see her relaxing.
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Depakote is used to treat aggression in dementia patients it works well for some and not for others this is true for all medication and if you read up on any medication there will be potential side effects to them most not good ones you then have to decide if the "sugar is worth the sweet" in other words is the benefit worth the possible side effect. There is no "magic pill" out there that will work on all issues and patients with dementia.
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IBlank5255, my Mom was put on Depakote and it was a dream come true. She was so aggitated, agressive and moody and this calmed her right down beautifully. I have never heard anything bad other than the message above. My Moms neurologist is the chief neurologist at our hospital and said depakote is the safest drug for dementia/alz patients and doesnt believe in antipsychotics like seraquel, says they are black labeled as dangerous for dementia . The first month on depakote she was very tired, then fine. She was a totally different person on it, calm and happy, even laughed and sang on it. I retired as a teacher and had many students on it with adhd who were on 3 times my moms dosage. Its an antiseizure medication to calm the brain, also used to calming dementia/alz brains. My Mom was on the sprinkles, I opened the capsules and put in pudding 3 times a day. Each time after about a year I tried reducing it and within days that anger was back and I put her on it again. Eventually I weaned her off to 2x a day, then nightly, then off, and she was fine as that agressive moodiness stage had passed after about 2 years. Mom lives with me so I watch her 24/7 in my home. There is no rhyme or reason for good and bad days with dementia, you will have that forever but on this med you wont see anger and she will be calmer, it takes a while to kick in. I didnt want to use any medication but to my surprise my Mom was happier on pills, than off pills. Dont be afraid, its very commonly prescribed for dementia if you have a good neurologist. Ask any adult daycare worker nurse how often they give it and you will see. Good Luck, this stage will pass and she will not need the klonopin anymore, which can make them unsteady on their feed and lots of ups and downs. The stares are also common, just hold her hand and be with her, put on music or sing, just be with her and she will be okay.
ps change of environment for dementia patients can be devastating and scary ! They get lonely, depressed and more confused. My doctor told the closest I can have Mom with one face/one place is best.
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Depakote is very dangerous for the heart has caused serious conditions with the heart even in patient with heart trouble it can cause hallucination and dreams so horrifying that it can kill them I have heart conditions and they put me on it within 1 month my conditions worsened mentally and physically I checked with another cardiologist and we took me off go on web md and read carefully all u can about it and see if there has ever been recalls or llamas suits partaining to the drug. If u don't like what u find tm to doc about the concern. Glad I did
Good luck and good caring
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