When off-label use goes bad

SeroquelI remember when they recommended this drug for my Mom a few years back. She had vascular dementia and was getting very agitated. The staff was having a hard time redirecting my Mom. They thought this medication might help.

A recent story in The Washington Post covers some of the issues as it related to off-label use — One of America’s most popular drugs — first aimed at schizophrenia — reveals the issues of ‘off-label’ use. This is just one of a number of stories I have seen about using varied drugs to “temper” (for lack of a better word) the behavior of residents in care communities.

Before this, when Mom was still with Dad in Independent Living, the doctor suggested and prescribed Ativan. It is at least prescribed for anxiety. However, my Mom would refuse to take it so when I knew events might bring on anxiety for Mom, I would put it into her Coke. I must admit that I’m not sure that was any better maybe than prescribing off-label uses for different drugs.

I do know that the one time my Mom freely took Ativan was before my Dad’s funeral. On that one day, she wanted a pill to help with the anxiety she was feeling.

Over time, I learned to better interact with Mom and could usually redirect any pre-anxiety events. After the first year of adapting, I never even considered the need for any behavior medication.

Did I change?

Did Mom change?

Did moving her to a community focused on caring for individuals with dementia eliminate the circumstances to bring on the anxiety?

I will never truly know. However, I do feel that the first year as you and your loved one is adapting to the changes in your relationship, and they are feeling in their lives is the most challenging stage.

Just know that they need an advocate, and the more you know the better. Confessed. 

One thought on “When off-label use goes bad

  1. People who are drafted into care partnering roles (i.e. just about everyone who is a care partner) need the right training in basic skills, and I put “the right” in there purposefully because there is a lot of misinformation out there about the way people with dementia are. They are no different than the rest of us in how they respond to stressful situations and it’s wrong that they are prescribed drugs to sedate them into compliance for convenience when other healthier, more life-affirming options exist.


    It’s mostly not the fault of care partners; it’s mostly the fault of a system gone awry and the greed associated with BigPharma and BigLTC coupled with lack of financial support for older adults from government.

    Sadly, no matter how you look at it or where you point the finger, it’s a disgrace.

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