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Re: To Selma Re Meds

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Hi Lin,

 

Many thanks for your reply. Actually I have just realised I gave the wrong

spelling for the drug - it should be Leporex. (I spelled as Laporex- Sorry

!!). This the brand name they use in Europe.

 

I believe, active ingredients is clozapine.  I might be wrong but I believe, in

the US, the brand name for this drug is Clozaril.

Many thanks for your help on this. Please let me know if you want me to find

more information.

 

Regards

Selma

Subject: To Selma Re Meds

To: LBDcaregivers

Date: Wednesday, July 30, 2008, 7:07 PM

Dear Selma,

 

I accidentally erased your message about antipsychotic meds. Could you please

repeat your quesion and the name of the drug you were asking about. Did you say

laporex? I can't find anything with than name through the pharmacologist I work

with: thought I would check it out, but he can't locate anything with that name.

The closest is Lexapro, which is just an antidepressant, not an antipsychotic.

 

So if you could repeat your message, I'd be glad to ask him - he really knows

dementia meds inside-out.

 

Take care,

 

Lin

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Dear Selma -

Well that was quick. I was just checking in once more before going home. Ah,

Clozaril. It is one of the two atypical antipsychotics recommended by many LBD

experts for agitation, scary hallucinations, etc. The other is Seroquel, which I

am told is " generally " handled somewhat better than Cloz. Here's what I learned

from the PharmD:

 

Lep was developed to treat schizophrenia - like Seroquel. In schizo, it's sort

of the med of last resort. It can icause restlessness, sleep disorders,

seizures, etc. It can also interact with even more meds than Sero, so get a meds

eval for your loved one to ensure it can, at least theoretically, be tolerated. 

(My words: a meds eval is best handled by a PharmD, not an MD - the former know

lots more about meds than even the best docs.)  In the US, those who take Cloz

go on a national register and must have a blood draw weekly to monitor for

serious side effects. Note this is not the case with Seroquel.

 

Antipsychotics can cause a " paradoxical reaction " - the very behaviors they are

intended to treat. That can happen with too high a dose, also. They are

carefully prescribed  - and even more so if a person is also taking other meds

like antidepressants, parkinson's meds, sleep meds, antianxiety meds, etc. All

that can build up in the system and cause very serious effects.

 

This isn't intended to scare you. Many people with LBD do well on Sero (my mom's

been on it 5 years - started at a very high dose and have tapered down in the

last several years to avoid the above problems - or Cloz.

 

My own advice - and I'm not a clinician - is to carefully review your mom's meds

with an expert, and if this is fairly new behavior, check for other medical

problems - infections, TIAs, etc. as well as new or changed environmental

issues. Many times behavior changes are due to the wrong meds, bad med

interactions, too high or too low dosages, or even timing of dosages. Sometimes

it's environmental. And sometimes it's " just " the LBD.

 

Please keep us posted and tell us what you decide to do. I'm glad to check on

other meds if that is helpful. The PharmD here where I work is a treasure!

 

Lin

Subject: To Selma Re Meds

To: LBDcaregivers

Date: Wednesday, July 30, 2008, 7:07 PM

Dear Selma,

 

I accidentally erased your message about antipsychotic meds. Could you please

repeat your quesion and the name of the drug you were asking about. Did you say

laporex? I can't find anything with than name through the pharmacologist I

work with: thought I would check it out, but he can't locate anything with

that name. The closest is Lexapro, which is just an antidepressant, not an

antipsychotic.

 

So if you could repeat your message, I'd be glad to ask him - he really

knows dementia meds inside-out.

 

Take care,

 

Lin

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Hi Lin,

 

Many thanks for your reply. Very helpful indeed.

 

I was just worried that Clozaril is not the correct drug for LBDs as she started

to get really aggresive. However I am more confident now after reading your

response. I suppose we need to find the right dose for her.

 

First her doctor tried Zeldox (Ziprasidone) which gave her a lot parkinsonism

symptoms. Although she wasnt aggresive but very sleepy. And her hallucilations

did not get better. Then her doctor tried  Serequal but it made her really

aggressive. When the dose was gradually increased to 200mg/day, she become

really depressed, confused and unhappy. So it really didnt work for her. 

Hallucilations and dellusions were increased.

 

Finally, we had to change to Clazoril as it was the only one that we havent

tried yet. 

 

Her sundowning symtoms (trying to go home all the time when she is actually at

home, want to talk to her mum & dad ( this is driving everyone crazy since she

is insist that they are alive) need to be controlled as much as possible as she

has started to be verbally abusive to everyone. It is not really her nature at

all.

 

We have just checked that she doesnt have UTI. I think it is just 'LBD'

progressing. She has diagnosed in 2003 so it started to get gradually worse as

expected.

 

She is currently taking the following medicines at the moment. I would like to

give her ALA as well as I heard it is really good when it is given together with

Omega 3 but I am not sure I am going to overdue it since LBD'er are really

sensetive to every medicine/vitamin.

 

10 - 10.30am:Exelon (6mg), Namenda, Cipram, Fludex, Aspiring, Neuvitan (B1

vitamin), Clozaril (1/4)

Lunch time (1 -2 pm) Omega 3, Co-Enzime 10 (200mg), Turmeric, Clozaril (1/2)

Evening (7 -8 pm):  Exelon, Namenda, Clozaril (1/2 at the moment but her doctor

would like to increase to 1)

Bed time: Zovatin

 

 

Many thanks to PramD and yourselves for your great help.

 

Regards

 

Selma

From: l pratt <lprattbethany@ yahoo.com>

Subject: To Selma Re Meds

To: LBDcaregivers@ yahoogroups. com

Date: Wednesday, July 30, 2008, 7:07 PM

Dear Selma,

 

I accidentally erased your message about antipsychotic meds. Could you please

repeat your quesion and the name of the drug you were asking about. Did you say

laporex? I can't find anything with than name through the pharmacologist I

work with: thought I would check it out, but he can't locate anything with

that name. The closest is Lexapro, which is just an antidepressant, not an

antipsychotic.

 

So if you could repeat your message, I'd be glad to ask him - he really

knows dementia meds inside-out.

 

Take care,

 

Lin

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