Have any of your parents gone on gabapentin for anxiety? My mother has post-COVID symptoms which she doesn’t understand, and got panicky when she got up from bed due to dizziness and/or shortness of breath.
The physical therapist suggested gabapentin to “get her over the hump” because once up for awhile, she is better.
Over the weekend she could no longer figure out how to call me- one of the last long term memory things that helped her communicate. Yesterday she did not get out of bed, so the medication is not helping with that. When I called her, she is still anxious to leave.
I am thinking of cancelling the medication and maybe hiring an aide to help her get up. She is in assisted living where she is a “tenant” so although the aides try, they are limited in how much they can do to cajole her and they are busy.
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Gabapentin is a prescription drug, so there should be a provider who Rxd it other than the PT who suggested it. I would contact that provider to inquire about the time course expected for the gabapentin to kick in and provide benefit vs the timing of her new symptoms and whether they could be from the gabapentin (certainly possible). Based upon that information, the decision to stop the medicine or continue should be made. It’s Monday, so hopefully your question can be addressed today.
I have been in communication with the MD this whole time (and the PT, and the assisted living director.) The PT and AL asked me to make the Rx happen, but I expressed reservations to all involved at the start given past experience with this med.
To be honest, there are many providers, including her MD, who tend to seek my opinion rather than the other way around. Not saying I am happy with that but it’s the reality.
So I was just curious if anyone else had seen cognitive decline on this med.
Big hugs @compmom. I take a low dose of gabapentin myself for hotflashes ; ). It’s a pretty mild, been around for a long time med that generally is used for migraines.
That said, in the elderly population, even common drugs can have side effects and interact with other meds. Do you have access to a gerontologist? Sometimes they can better assess drug interactions.
A lot of her doctors are kind of “whatever.” They are pretty busy. My siblings are kind of “well, what’s wrong with her being in bed”?
It is an interesting situation. She does not understand that she is suffering from the effects of COVID. It is impossible to get her to understand this.
Once she is up she is much better and happier. So that is why I am concerned with her being in bed. She just has to get over the fear she experiences when she first gets up and is out of breath. She does not comprehend it.
Once downstairs she does a puzzle and talks to people and has some quality of life still Otherwise I would go for a more palliative approach and go with the bed ridden scenario!
The psychiatrist at the community mental health clinic where I work sometimes uses Gabapentin for clients on heavy-duty drugs (e.g. Aricept) for psychosis who have breakthrough symptoms or sleep problems usually due to extra stressors. I agree that the prescriber should be contacted. Something else might work better.
Her heightened anxiety may be with the progressive dementia and feeling of lack of control. Gabapentin is not only a prescription drug but it is also a controlled substance classification (a lower level one, but it is a controlled substance).
@compmom Always a balancing act, with medications, therapies, senior interactions, and interactions with facility personnel.
Also be careful - in assisted living there are criteria for staying in assisted living. She has more freedom. Once she does not meet assisted living criteria, her life will change. Keep up as long as you can with the balancing act.
@SOSConcern how thoughful of you to respond when you are going through a hard time
I have been suggesting a private aide for the last week and the AL nursing director just said I should hire one (of course without referring to my suggestion, so it feels now like a requirement). I have asked if I can refuse the med with an invoked proxy and also contacted the MD. Gabapentin affected her cognitively in the past and this time she has forgotten how to use her phone, as I said. The PT had to spend time helping her get up (we pay $9k+ for assisted living but they cannot do this!) and I said that normally I can help get her ready by phone. Today I was in an MD appt. myself. I do think additional companionship might be nice until I can go in her room. I am visiting twice a week at the window.
My mother is already on the edge with her colostomy care. They almost didn’t allow that but I made it easy for them, trained staff, wrote instructions and provided all supplies. Now I have hired a private nurse for that during COVID.
I wanted to move her to a memory care place (freestanding) but COVID interfered and now I am not sure they would take her. They would get her up! Calling them today just to find out their entrance prohibitations.
@somemom LOL. My DH will sit and listen to me repeat the same thoughts over and over, in different phrases and then sometimes say “Maybe you’d do better to write this in your journal”. He’s a saint.
@compmom My dad was on gabapentin for pain and anxiety. (And our dog, who we had to put down 1 week before dad died was on gabapentin too, for dementia-related anxiety. I had many months of having to make sure I had my notes right before talking to the vet or the MD )
It’s hard to tell if the gabapentin affected him cognitively. He was naturally declining anyway. We worked with a geriatric psychiatrist who really knew her stuff. He was also on an SSRI and Ativan or Xanax PRN to manage anxiety.
If you have already had a bad experience with it, perhaps it is worth trying something else though.
My mother in law was in memory care for the last few years of her life until she died at 91. Once she could not remember how to walk, she ended up in a wheelchair. The memory care unit did not provide any included assistance with keeping her walking so check what any facility you are considering will provide as included. This was an expensive continuing care community that we dealt with, starting with independent living , then assisted living, then memory care. She was well cared for in the memory care unit but at some point her walking became a problem and the goal really became keeping her safe and comfortable. It’s a sad, stressful end for many families. All the best to you.
@surfcity, in truth, my sister has been my lifesaver, too faraway to help physically, she has been my listener for over a decade of being responsible for Mom. Saved my sanity and possibly my marriage as I was somewhat sensitive to not just vent to my DH.
I have made a lot of calls today- doctor, nursing agency for aides, PT and had a long talk with the memory care facility. You are all so helpful. Thank you! And thoughts to those who are suffering recent losses.
Just had a long talk with the director of the nursing agency. Her mom got COVID around Easter and was in ICU. Her dementia and Parkinson’s was worsened and the assisted living would not take her back. She has been in a nursing home and they have not been able to visit at all. The woman at the agency told me that she tried to get her mother moved to a better place but her mom didn’t want to go and they were going to use restraints so she just kept her there.
It’s funny, I teared up at her story but with our own stories we tend to just soldier on, right? We agree that when this is over we will go out for martinis!
@compmom- you are sorting out so much. I hope that your calls were helpful and have been there myself with navigating ambiguity about medications and that cost/benefit analysis. Seems an aide could be very helpful to both your mother and you. You described your mother as having challenges pre-Covid, now there is the process of re-grouping and assessing how close to her prior baseline she can get. Seems likely an aide will provide valuable support to her and perhaps optimize her chances to be more comfortable, while providing you with some good input.
Given your concerns about her eligibility for the memory care unit, I wonder if it is also an AL facility, as opposed to a skilled nursing memory care option. My father with dementia eventually moved from AL to an excellent skilled nursing memory care unit and it was great for him. While initially I had that general hesitancy to move to the next level of care, further investigation reduced most of my concerns and revealed how hard he was working to keep up in the AL environment. It was a good fit to have built-in medical care, lots of well designed activities, all with a staff prepared to optimize engagement and no worries about ‘the other shoe dropping’. There is tremendous variation in what works best and when, mentioning this in case it is a consideration.
Sending all good thoughts for the way forward. It is a such a process and you have been an extraordinary support for your mother.
Once I am vaccinated I can visit most days, the way I used to, and can help with a lot of these things. So just 6-8 weeks to go. (I had to cancel a couple of vaccination appointments because I have been sick.)
The memory care place that I have been considering for some time has no skilled nursing. It is freestanding. Her current assisted living has a memory care unit but it is mostly folks who are completely non-verbal. My mother doesn’t have the mobility to wander!
At this point a skilled nursing memory care place would be ideal. @travelnut so glad you found a good situation for your father.
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