My husband has EOAD (probably in mid-6 stage) and is now much more confused because he is taking meds for herniated disk--Prednisone, Tylenol #3, etc.--along with his regular AD medications. This is his 2nd day of Prednisone and he has been VERY confused the last few hours. Anyone have any thoughts on this?

Very frightened about this...
MJ in South Alabama, USA

prednisone can indeed cause confusion and mood swings. This usually abates when the drug is discontinued.

MJ,

Oh, yes, my mom was on a low dose of prednisone, with occasional injections of it, for rheumatoid arthritis for about a year and a half. Her dementia continued to worsen throughout that time, despite the AD medicines. She has been off prednisone for several months now, and is much more lucid and less confused.

Thanks for reassurance, Meeko and DJ...

M J

Please make sure your husband follows the Dr's directions for taking the Prednisone and never just discontinue it. It must be stepped down gradually. I'm currently on it (and I don't have AD) and I got into trouble when my Dr tried to step my dosage down too quickly.

Terri, Thanks for advice; however, in this situation my HB is taking a week's supply that has a descending number of pills each day. I'm hoping he doesn't have to have more after this.

The Tylenol 3 may be contributing to it as well.
It made my Grandma "crazy."

You should be fine if he's only got a weeks supply. I've been on it for over a month now and we're having a terrible time stepping my dosage down. My adrenal system doesn't seem to want to kick and start producing the corticosteriod on it's own and I'm having all sorts of problems.

Good luck

MJ:

I am sorry you are going through this. As if AD and AD meds alone are not frightening enough.

Did you talk to the doctor about your husband's reaction to the prednisone? I would be interested to know what his thoughts were. Is there another pain/inflammation med that might not be so harsh on an AD patient?

I am glad so many people responded to the steriod step down issue. Not all doctors insist on the step down procedure, and it is so important. Drugs like prednisone can be a miracle cure for inflammation but can also cause many other problems, especially when taken over long periods of time.

It brings up an interesting question though. If inflammation is a potential culprit in AD, does anyone know if any therapies have been tried with other steriods as a treatment?

I am not sure what Tylenol 3 is used for, but we had trouble with Tylenol P.M.

A number of years ago, when My Mom was still okay, she took it without realizing that the ingredient that helps makes you drowsy is an antihistamine. She is allergic to antihistamines and has a paradoxal reaction – making her hyper rather than sleepy. Another OTC med into the trash.

I hope your husband's back will be better soon, and he can discontinue the other meds.

Kit

My dad's parents both developed serious Alzheimer's before they passed. My dad had trouble with one of the new wonder drugs for cholesteral (I think Lipitor?) that caused him to loose most of his memory which ceased as soon as he stopped taking it. Now he has been diagnosed with polymyalgia-rhuematica and is taking prednisone. In addition to the advertised side effects he is once again exhibiting classic Alheimer's symptoms. Can anyone comment on similar experience?

I'm so sorry your dad has polymyalgia. I've had it for the last 4 years. I'm on minimal steroids right now, but that last step down to being completely off them just isn't happening. Dr. says stress ...

I can't imagine what it must be like trying to step down the steroids with Alzheimer's. My thoughts are with you both.
Marie

We got the results of my HB's MRI & X-ray and he has bulged disk L-4, L-5 and herniated disk S-1. Today, we went for a pain management steroid injection into his spine. He seems to be doing OK so far tonight. His AD symptoms are getting much worse since this bad flare-up with his back. The pain management doctor said that there is a 75% chance that the injections will work to control the pain, BUT that means there's a 25% chance that back surgery will be needed. That would not be a good thing at all.

I'm tired... so tired.

quote:

Originally posted by jellybeans:
The Tylenol 3 may be contributing to it as well.
It made my Grandma "crazy."

I do believe that the Tylenol #3 is making his confusion worse. I've stopped giving him the 4xday RX and have tried to cut it to 2xday if he can get by with it.

quote:

Originally posted by Kit5862:
MJ:

I am sorry you are going through this. As if AD and AD meds alone are not frightening enough.

Did you talk to the doctor about your husband's reaction to the prednisone? I would be interested to know what his thoughts were. Is there another pain/inflammation med that might not be so harsh on an AD patient?

I am glad so many people responded to the steriod step down issue. Not all doctors insist on the step down procedure, and it is so important. Drugs like prednisone can be a miracle cure for inflammation but can also cause many other problems, especially when taken over long periods of time.

It brings up an interesting question though. If inflammation is a potential culprit in AD, does anyone know if any therapies have been tried with other steriods as a treatment?

I am not sure what Tylenol 3 is used for, but we had trouble with Tylenol P.M.

A number of years ago, when My Mom was still okay, she took it without realizing that the ingredient that helps makes you drowsy is an antihistamine. She is allergic to antihistamines and has a paradoxal reaction – making her hyper rather than sleepy. Another OTC med into the trash.

I hope your husband's back will be better soon, and he can discontinue the other meds.

Kit

There's so much bad press about Tylenol these days that I'm almost afraid to use it (its effects on the liver). My HB is on Exelon Patch, Namenda, Lexapro, Neurontin, Flomax, Prilosec, and Claritin on a regular basis. Now, with the back issue and the additional meds, I don't know how his body knows what to do with it all. Medicine, medicine, medicine... our lives are filled with pill bottles!

I'm jumping in here with an opposite experience. My 89-yr-old AD mom has been on Prednisone now for about a year at gradually decreasing dosages (for Giant-cell Arteritis, also known as Temporal Arteritis). I think this steroid has made her more lucid than she was before! At one point they decreased it too fast and her SED rate started to go up again, and when they upped it a little I noticed a definite "up" change in her cognition. She had been gradually going "down" again that was kind of corresponding to the decreased dosage of Prednisone. I also wondered about having read somewhere that inflammation in the brain could be related to dementia in some way. Seems to me these experiences just prove that everyone is different in how drugs work on them.

Hi, I’ve been looking at this forum for some months now (a great source of comfort and information by the way – thank you everyone!) but this is my first post. My mum was officially diagnosed with AD a couple of years ago but had exhibited symptoms for some time. She had been on predisone for some years previously for a lung condition and it was working marvelously for her. Despite being warned by her original doctor that she should not try to come off predisone completely because it would never work as well the second time around, a new doctor took her off it and this coincided not only with a rapid decline in her lung condition but also with the onset of AD. Like Ruth I feel that the anti-inflammatory effect of prednisone had kept AD at bay and that trying to take her off it brought about a dramatic turn for the worse, though of course the resulting greater lack of oxygen flow due to a worsening of her lungs could also have played a role.

But it’s also true that steroids can work great for some people and can make other people worse in many different ways (I know of people with the same lung condition as my mum who were actually made much worse by it). Steroids are definitely known to make patients more aggressive, which is probably why when my mum was taken into hospital a few months ago during an agressive behaviour phase, the first thing they did was to drastically reduce her steroids, much to our dismay, because they are the only things that can help with her lungs. It was only for a few days so can’t say if it made confusion better or worse in that particular case, but stopping them completely approx 3 years ago DEFINITELY contributed to the onset of AD or a significant worsening of previously unnoticeable symptoms.

Hi MJ,
First I just wanted to say that I'm sorry you're dealing with so much.

Second, I don't know anything about the Prednisone because my mom never took it. But I can't imagine an AD patient doing well with Tylenol 3. That stuff knocks me out cold. I can barely function on it, and I'm only 47 y.o.

The last thing I wanted to mention was the back surgery. I noticed that you are new here (at least it looks like it by your number of posts). Before you decide on back surgery, please do a search here on anesthesia. It can really be tough on AD patients. There are alot of posts on this subject. I realize there may be no options as far as surgery, but there are options about what type of anesthesia you use.

Take care, and post often. We all care.

I have discussed the possible negative outcomes of general anesthesia with several doctors. There is no way that I would agree to back surgery for my husband unless it were an absolutely last resort. The general consensus among the doctors was that the AD could be exacerbated by the effects of anesthesia; however, I did have one doctor who completed disagreed on that point.

My HB has been on various NSAIDS over the last decade or so. His disk problems are so bad at this point that we basically had to go to steroids. I'm looking at palliative care now. I want him to be comfortable and without pain even if the dementia symptoms are worse for a while.

Thanks for input...

Ruth, your mom does not have AD ... she has giant-cell arteritis dementia (aka temporal arteritis dementia), which is one of the "treatable" dementias, and the treatment is high levels of corticosteroids such as Prednisone. E.g., go to:

http://www.ncbi.nlm.nih.gov/pubmed/18363015

and click on the link to the free .pdf file.

Also:

http://pmj.bmj.com/cgi/content/full/80/941/125

http://jnnp.bmj.com/cgi/conten...tract/76/suppl_5/v15

http://www.medlink.com/web_content/MLT0008Z.asp
(Requires free registration to see full article.)

MJ, I looked into the claims that anesthesia causes dementia very thoroughly. There have been many studies, and none of them showed that it did. The better ones found a number of other risk factors, however, including certain medicines that are given pre- and post-op. Also, the hospital environment can be distressing, and possibly lead to delirium, which is a risk factor for worsening dementia.

There are plenty of things you can do to minimize the impact of the surgery and the stay in the hospital, if your husband absolutely has to have an operation. See:

http://alzheimers.boomja.com/A...nesthesia-48738.html