Question about Remeron...

[Guest guest]

I’d love to know your experiences with Remeron in caring for you LO.

Mom was started on Remeron on 2/12.

There was nearly an overnight – night and day – change/improvement in Mom.

Her affect became so bright, animated, engaged – even if perhaps a little

overexaggerated – it was amazing. For the first time she became – dare I

even say it – happy – about becoming a part of the community in which she

lives. (She’d actually acclimated well – it was just with a very flat

affect prior to this introduction of medication!) She was singing (she

never sang in previous life!), dancing (she’s always avoided dancing!),

playing animatedly with the group’s balloon toss game, or taking part in the

daily craft or exercise activities. She seemed FAR more likely to recognize

someone when they entered the room – getting the right name with the right

face more times than not.

IT WAS AMAZING!

I had the staff calling me – nearly in tears of joy – over the huge change –

for the better, of course – that they’d witnessed in my Mom.

It was the first time in four months that she wasn’t exit-seeking, obviously

deeply depressed, and begging me to help her end her life.

That medication change was the week of February 12th – as stated previously.

The tiny cracks in the super bright façade began to show themselves about a

week and a half later.

I see Mom daily – sometimes for less than an hour – other times for several

hours at a time. I feel that the care givers at the facility are honest

with me and – honestly – love Mom – some days might even be construed as

being a little bit too much emotionally involved in her care – as wacky as

that may seem. So, when I say something to them – or they say something to

me – and all of the notes are aligning to reveal that we’re seeing the same

types of things – I take it seriously.

Mom started slowly – gradually – spending more time in bed again.

Then sleeping a little less each night.

Then the bright effect lost some of it’s brightness – the pasted on smile

would drop away – completely – sometimes when she forgot to keep it up.

Some paranoia began to be expressed.

Pronounced feelings of longing to end her life began surfacing again.

Nonsensical statements became more common place – i.e., when I came to do

her hair the other day she mentioned she’d lost her head, so we couldn’t do

her hair. Or, a fascination with a belief that there were other worlds out

there and people were being taken away to them, etc.

At first it was little chinks. Gradually, by about two weeks ago, we were

back to the place we started when the medication change had taken place –

the bright affect would occasionally surface – ever so briefly.

By the 11th of March, we had far surpassed the starting point, and she was

to an all new emotional low. She was deeply depressed. On top of that, she

was experiencing this all-consuming emotional agony that she alone is

responsible for the damnation of mankind. She’s always been a woman of

faith – with a life characterized by grace, love, peace, and an incredible

kindness. Her frame of mind at that point - a grossly misrepresented

exaggeration of a religious nature – not at all like the faith she once

embraced. She was literally in AGONY over this – to the point of starting

to grasp her hair and pull, weep, etc.

For a couple of weeks now the general consensus is that she’s getting little

or no sleep.

Her paranoia is much more pronounced.

She is spending nearly all of her time in bed again.

She cannot be redirected or encouraged to focus elsewhere – when consumed by

this huge burden of misplaced guilt (which is about 90% of the time).

Okay – so on the 14th of March I had her back to the doctor for her

regularly scheduled med check-up. Much of the above was in an email I’d

sent him before we actually saw him. He went ahead and tweaked the meds a

bit, and mentioned that it’s not unusual for there to be a “settling” affect

with the Remeron, and that maybe we should attempt an INCREASE in medication

in order to determine if that was what she needed. (She’d been started on a

fairly low dose initially.) (I should probably also add that this is the

doc who is THE guy that EVERYONE (regionally, at least) looks to for the

latest and most current info/feedback in regard to LBD – he just GETS it.

He’s so clued in and so on top of stuff! And, he’s really kind.)

So, the med increase started 3/14. The first 24 to 48 hours she was bright

(effusive) – but not super bright like the first time. I spent several

hours with her Friday evening, and I noticed a little more paranoia than

we’d seen for a while. I wasn’t able to get there Saturday – I’m trying to

get her Condo on the market by end of the week. Then last evening was there

for quite a while.

She’s so DOWN. Beyond sad – truly depressed. Totally flat effect. Total

monotone voice. No smile at anything. Back to extreme paranoia about not

having clothing, or a place to sleep, or food to eat (she has excess of all,

of course). Hence, she is reluctant – to the point of borderline combative

– to change into clean clothing or bathe again.

Sigh!

Anyone else see this? It’s so completely different from the first time out

with the initial dose of the Remeron – it seems so wacky!

I’d love input!

BTW – here’s her med list:

Aricept (10 mg QD)

Lexapro (10 mg QD)

Synthroid (75 mcg QD)

Lorazepam (1 mg Qam, 3 mg HS)

Tylenol (650 MG TID)

Remeron (30 mg QHS)

Thanks,

Dina

Care Manager to Mom, aged 66

dx'd with LBD 10/2006

[Guest guest]

Oh, Dina, I really feel for you. That is very upsetting.

My Mom has been on Remeron for quite a few months. It made her much

calmer, relaxed, happy--and she was sleeping better. She still seems OK,

but she talks for hours during the night again at times.

" Dina "

<dinacmcb@comcast

.net> To

Sent by: <LBDcaregivers >

LBDcaregivers@yah cc

oogroups.com

Subject

Question about

03/19/2007 12:02 Remeron...

PM

Please respond to

LBDcaregivers@yah

oogroups.com

I’d love to know your experiences with Remeron in caring for you LO.

Mom was started on Remeron on 2/12.

There was nearly an overnight – night and day – change/improvement in Mom.

Her affect became so bright, animated, engaged – even if perhaps a little

overexaggerated – it was amazing. For the first time she became – dare I

even say it – happy – about becoming a part of the community in which she

lives. (She’d actually acclimated well – it was just with a very flat

affect prior to this introduction of medication!) She was singing (she

never sang in previous life!), dancing (she’s always avoided dancing!),

playing animatedly with the group’s balloon toss game, or taking part in

the

daily craft or exercise activities. She seemed FAR more likely to

recognize

someone when they entered the room – getting the right name with the right

face more times than not.

IT WAS AMAZING!

I had the staff calling me – nearly in tears of joy – over the huge change

–

for the better, of course – that they’d witnessed in my Mom.

It was the first time in four months that she wasn’t exit-seeking,

obviously

deeply depressed, and begging me to help her end her life.

That medication change was the week of February 12th – as stated

previously.

The tiny cracks in the super bright façade began to show themselves about a

week and a half later.

I see Mom daily – sometimes for less than an hour – other times for several

hours at a time. I feel that the care givers at the facility are honest

with me and – honestly – love Mom – some days might even be construed as

being a little bit too much emotionally involved in her care – as wacky as

that may seem. So, when I say something to them – or they say something to

me – and all of the notes are aligning to reveal that we’re seeing the same

types of things – I take it seriously.

Mom started slowly – gradually – spending more time in bed again.

Then sleeping a little less each night.

Then the bright effect lost some of it’s brightness – the pasted on smile

would drop away – completely – sometimes when she forgot to keep it up.

Some paranoia began to be expressed.

Pronounced feelings of longing to end her life began surfacing again.

Nonsensical statements became more common place – i.e., when I came to do

her hair the other day she mentioned she’d lost her head, so we couldn’t do

her hair. Or, a fascination with a belief that there were other worlds out

there and people were being taken away to them, etc.

At first it was little chinks. Gradually, by about two weeks ago, we were

back to the place we started when the medication change had taken place –

the bright affect would occasionally surface – ever so briefly.

By the 11th of March, we had far surpassed the starting point, and she was

to an all new emotional low. She was deeply depressed. On top of that,

she

was experiencing this all-consuming emotional agony that she alone is

responsible for the damnation of mankind. She’s always been a woman of

faith – with a life characterized by grace, love, peace, and an incredible

kindness. Her frame of mind at that point - a grossly misrepresented

exaggeration of a religious nature – not at all like the faith she once

embraced. She was literally in AGONY over this – to the point of starting

to grasp her hair and pull, weep, etc.

For a couple of weeks now the general consensus is that she’s getting

little

or no sleep.

Her paranoia is much more pronounced.

She is spending nearly all of her time in bed again.

She cannot be redirected or encouraged to focus elsewhere – when consumed

by

this huge burden of misplaced guilt (which is about 90% of the time).

Okay – so on the 14th of March I had her back to the doctor for her

regularly scheduled med check-up. Much of the above was in an email I’d

sent him before we actually saw him. He went ahead and tweaked the meds a

bit, and mentioned that it’s not unusual for there to be a “settlingâ€

affect

with the Remeron, and that maybe we should attempt an INCREASE in

medication

in order to determine if that was what she needed. (She’d been started on

a

fairly low dose initially.) (I should probably also add that this is the

doc who is THE guy that EVERYONE (regionally, at least) looks to for the

latest and most current info/feedback in regard to LBD – he just GETS it.

He’s so clued in and so on top of stuff! And, he’s really kind.)

So, the med increase started 3/14. The first 24 to 48 hours she was bright

(effusive) – but not super bright like the first time. I spent several

hours with her Friday evening, and I noticed a little more paranoia than

we’d seen for a while. I wasn’t able to get there Saturday – I’m trying

to

get her Condo on the market by end of the week. Then last evening was

there

for quite a while.

She’s so DOWN. Beyond sad – truly depressed. Totally flat effect. Total

monotone voice. No smile at anything. Back to extreme paranoia about not

having clothing, or a place to sleep, or food to eat (she has excess of

all,

of course). Hence, she is reluctant – to the point of borderline combative

– to change into clean clothing or bathe again.

Sigh!

Anyone else see this? It’s so completely different from the first time out

with the initial dose of the Remeron – it seems so wacky!

I’d love input!

BTW – here’s her med list:

Aricept (10 mg QD)

Lexapro (10 mg QD)

Synthroid (75 mcg QD)

Lorazepam (1 mg Qam, 3 mg HS)

Tylenol (650 MG TID)

Remeron (30 mg QHS)

Thanks,

Dina

Care Manager to Mom, aged 66

dx'd with LBD 10/2006

[Guest guest]

We saw the same thing with Cal; he did pretty well on Remeron, but

dose adjustments were increasingly short-lived - ie, he was stable on

15 mg for two years, but then 30 mg only lasted a year, 45 mg only

lasted six months, 60 mg was only tolerated for two weeks.

Remeron is sedating - this is great for people who aren't sleeping.

It's also exceptionally well-tolerated in the elderly - I believe in

geriatrics as a whole, it's a preferred agent.

I've become a huge believer in psychostimulants, especially for

apathy, delusions and hallucinations. I was initially extremely

skeptical, but the benefits were immediate, have been completely

sustained and are well-documented in the clinical literature. The

combo of something fast-but-short acting (dextroamphetamine at 8 AM)

and slower-to-act-but-longer-lasting (modafinil at 8 AM) has been

nothing short of miraculous. For anyone struggling with a

grogged-out, uninvolved or hallucinating/fearful LO, consider the

stimulants, even if it doesn't " make sense " - I was convinced that

giving someone who was wacky a stimulant would make them wide awake

and more floridly wacky. Boy, was I wrong.

Cal stopped taking the Remeron altogether when he was sleeping 20

hours a day (shortly before his diagnosis). His psychiatrist now

prescribes a combo of two amino acid supplements - 50 mg of 5-HTP (a

form of tryptophan that metabolizes to serotonin) and 250 mg of

L-tyrosine, which is involved in dopamine synthesis. The combination

seems to work as well as the Remeron at promoting sound sleep and

cheery mood.

[Guest guest]

-- I don't quite understand... BUT I like the sound of

something that WORKS! So will save this post in the Links section under

Meds that Work for others...

[Guest guest]

dina --

i have nothing practical to offer -- sorry -- but i

just want you to know i'm thinking of you --- sorry to

hear of the ups and downs --- - must be sooooo hard

to see the " crash " after the happiness of the high.

hang in --

my thoughts are with you --

xo

anna

--- Dina wrote:

> I’d love to know your experiences with Remeron in

> caring for you LO.

>

>

>

> Mom was started on Remeron on 2/12.

>

>

>

> There was nearly an overnight – night and day –

> change/improvement in Mom.

> Her affect became so bright, animated, engaged –

> even if perhaps a little

> overexaggerated – it was amazing. For the first

> time she became – dare I

> even say it – happy – about becoming a part of the

> community in which she

> lives. (She’d actually acclimated well – it was

> just with a very flat

> affect prior to this introduction of medication!)

> She was singing (she

> never sang in previous life!), dancing (she’s always

> avoided dancing!),

> playing animatedly with the group’s balloon toss

> game, or taking part in the

> daily craft or exercise activities. She seemed FAR

> more likely to recognize

> someone when they entered the room – getting the

> right name with the right

> face more times than not.

>

>

>

> IT WAS AMAZING!

>

>

>

> I had the staff calling me – nearly in tears of joy

> – over the huge change –

> for the better, of course – that they’d witnessed in

> my Mom.

>

>

>

> It was the first time in four months that she wasn’t

> exit-seeking, obviously

> deeply depressed, and begging me to help her end her

> life.

>

>

>

> That medication change was the week of February 12th

> – as stated previously.

> The tiny cracks in the super bright façade began to

> show themselves about a

> week and a half later.

>

>

>

> I see Mom daily – sometimes for less than an hour –

> other times for several

> hours at a time. I feel that the care givers at the

> facility are honest

> with me and – honestly – love Mom – some days might

> even be construed as

> being a little bit too much emotionally involved in

> her care – as wacky as

> that may seem. So, when I say something to them –

> or they say something to

> me – and all of the notes are aligning to reveal

> that we’re seeing the same

> types of things – I take it seriously.

>

>

>

> Mom started slowly – gradually – spending more time

> in bed again.

>

>

>

> Then sleeping a little less each night.

>

>

>

> Then the bright effect lost some of it’s brightness

> – the pasted on smile

> would drop away – completely – sometimes when she

> forgot to keep it up.

>

>

>

> Some paranoia began to be expressed.

>

>

>

> Pronounced feelings of longing to end her life began

> surfacing again.

>

>

>

> Nonsensical statements became more common place –

> i.e., when I came to do

> her hair the other day she mentioned she’d lost her

> head, so we couldn’t do

> her hair. Or, a fascination with a belief that

> there were other worlds out

> there and people were being taken away to them, etc.

>

>

>

> At first it was little chinks. Gradually, by about

> two weeks ago, we were

> back to the place we started when the medication

> change had taken place –

> the bright affect would occasionally surface – ever

> so briefly.

>

>

>

> By the 11th of March, we had far surpassed the

> starting point, and she was

> to an all new emotional low. She was deeply

> depressed. On top of that, she

> was experiencing this all-consuming emotional agony

> that she alone is

> responsible for the damnation of mankind. She’s

> always been a woman of

> faith – with a life characterized by grace, love,

> peace, and an incredible

> kindness. Her frame of mind at that point - a

> grossly misrepresented

> exaggeration of a religious nature – not at all like

> the faith she once

> embraced. She was literally in AGONY over this – to

> the point of starting

> to grasp her hair and pull, weep, etc.

>

>

>

> For a couple of weeks now the general consensus is

> that she’s getting little

> or no sleep.

>

>

>

> Her paranoia is much more pronounced.

>

>

>

> She is spending nearly all of her time in bed again.

>

>

>

> She cannot be redirected or encouraged to focus

> elsewhere – when consumed by

> this huge burden of misplaced guilt (which is about

> 90% of the time).

>

>

>

> Okay – so on the 14th of March I had her back to the

> doctor for her

> regularly scheduled med check-up. Much of the above

> was in an email I’d

> sent him before we actually saw him. He went ahead

> and tweaked the meds a

> bit, and mentioned that it’s not unusual for there

> to be a “settling” affect

> with the Remeron, and that maybe we should attempt

> an INCREASE in medication

> in order to determine if that was what she needed.

> (She’d been started on a

> fairly low dose initially.) (I should probably also

> add that this is the

> doc who is THE guy that EVERYONE (regionally, at

> least) looks to for the

> latest and most current info/feedback in regard to

> LBD – he just GETS it.

> He’s so clued in and so on top of stuff! And, he’s

> really kind.)

>

>

>

> So, the med increase started 3/14. The first 24 to

> 48 hours she was bright

> (effusive) – but not super bright like the first

> time. I spent several

> hours with her Friday evening, and I noticed a

> little more paranoia than

> we’d seen for a while. I wasn’t able to get there

> Saturday – I’m trying to

> get her Condo on the market by end of the week.

> Then last evening was there

> for quite a while.

>

>

>

> She’s so DOWN. Beyond sad – truly depressed.

> Totally flat effect. Total

> monotone voice. No smile at anything. Back to

> extreme paranoia about not

> having clothing, or a place to sleep, or food to eat

> (she has excess of all,

> of course). Hence, she is reluctant – to the point

> of borderline combative

> – to change into clean clothing or bathe again.

>

>

>

> Sigh!

>

>

>

> Anyone else see this? It’s so completely different

> from the first time out

> with the initial dose of the Remeron – it seems so

> wacky!

>

>

>

> I’d love input!

>

>

>

> BTW – here’s her med list:

>

>

>

> Aricept (10 mg QD)

>

> Lexapro (10 mg QD)

>

> Synthroid (75 mcg QD)

>

> Lorazepam (1 mg Qam, 3 mg HS)

>

> Tylenol (650 MG TID)

>

> Remeron (30 mg QHS)

>

>

>

> Thanks,

>

>

>

> Dina

>

>

>

> Care Manager to Mom, aged 66

>

> dx'd with LBD 10/2006

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

________________________________________________________________________________\

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[Guest guest]

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Imogene

In a message dated 3/19/2007 11:47:38 AM Central Standard Time,

octoryrose@... writes:

-- I don't quite understand... BUT I like the sound of

something that WORKS! So will save this post in the Links section under

Meds that Work for others...

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