Hello and thank you for your question. I'm sorry to hear about this gentleman. Lorazepam is not the best medication to handle agitation in individuals with advanced Alzheimer's dementia. My suggestion for you is to first determine why he is getting worse. Sometimes infections such as UTI and upper respiratory infections can lead to worsening of mental status. Treating the underlying cause can improve behavior. However, if the behavioral change has been getting worse progressively, my suggestion would be for you to try a medication called quetiapine. Alternative to quetipine is aripiprazole. Both of these medications may be used for treating agitation. He may need to by psychiatrist in order for either of these medications to be prescribed.
Lyrica dosing should have no bearing on his mental status. If anything, it can make him lethargic. It should not make him more agiatated. As for the UTI, you will have to allow him some time to recover from the infection before you a notable change in his mental status. Two weeks is often insufficient for patients to get back to their baseline.
You will need to speak to your GP regarding a psychiatry evaluation.
You should not change the dosing of either. Discontinuing lorazepam would not be advisable. This medication needs to be weaned off.
No they are not incompatible for patients with slow heart rate. Neither of the medications that you mentioned should interact with quetiapine or aripiprazole.
Lyrica is a medication for neuropathic pain and is also indicated as an anti-seizure medication. I have seen some psychiatrists you it for anxiety, however its benefit for this purpose is not well known.
Lyrica is not indicated for treating dementia or agitation
Since he is displaying signs of severe agitation, a psychiatrist would be more appropriate choice.
I'm not sure that the Lyrica was doing anything at all to begin with
Since Lyrica has a sedating effect it may have more likely put him to sleep instead of controlling his behavior.
I think a psychiatrist (or may be a geriatrician) would be the best person to consult. I suggest you insist on the referral.
Not really...it should have no bearing...however you should not stop the lorazepam
Abruptly stopping lorazepam can lead to seizures.
I would have the GP wean it down gradually.
Not really hazardous...but inappropriate
it can work on short notice....but not good for preventing agitation
yes you can come back to the chat
I am a board certified neurologist in practice in the US for 12 years
I understand. This is an international website so you can got a physician from almost anywhere.. In this case you have one from the US
You may need to pay again since you may have another physician answering the question.
You can also request me.
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Thank you!..sipping as we chat.