Philippe,PhilD wrote: ↑Sat Feb 18, 2023 5:31 am Robin is getting delirious day after day. She has been in hospital to be tested for the cause of it and her biochemistry is normal . She also does not have UTI. So my question is . Is it normal for people with Alzheimer to finish up with being delirium constantly ? If not , what can I do to stop it ??
I'm so sorry to hear that Robin is again struggling with delusions and agitation on a daily basis. My non-expert understanding, from listening to a few talks on this, is that sometimes the brain in later Alzheimer's loses the connections needed to understand or process all the info from our five senses and the experience of that causes confusion, agitation and sometimes delusions. [Lots of people, me included, have tinnitus or ringing in the ears, after a high frequency hearing loss, Our brains also are trying to make sense of the missing sounds by producing sounds that can't be heard by anyone else.]
Here's some background from an upcoming 4-year double-blind trial using 12 weeks of CBD and THC (or placebo) for agitation in the LIBBY Study in the US. It is starting this year, using very carefully sourced and regulated THC and CBD oils (orally) for treatment of what they term "agitation", but which includes delusions and delirium, in late stage dementia.
The people in this study are going to be in "hospice", at home or in a long-term care facility, which in the U.S. that can be longer than 6 months for people with dementia. The families of these patients will be the ones to provide "informed consent" and will be closely involved.Approximately fifty percent of people diagnosed with Alzheimer’s disease (AD) or other types of dementia will receive hospice care at the end of their life. Of these, over seventy percent will be prescribed psychiatric medications for management of agitation. There are no approved treatments or guidelines to assist clinicians in addressing end of life agitation in dementia. In the absence of appropriate evidence-based guidelines, patients are typically prescribed a combination of anti-psychotics, sedatives, and opiates. These medications often lead to undesirable side effects including confusion, constipation, itching, tremors, and muscle contractions, all of which tend to make the situation even worse, lowering quality of life for patients, and adding burden to their care partners.
Recent research suggests that derivatives of cannabis (some of the chemicals found in marijuana) can be beneficial in controlling agitation and distress without the side effects of medications commonly used to treat agitation.
IMPORTANT NOTE: This is not something you want to try at home with locally-sourced CBD oil or marijuana, since the components of those may vary widely and cause serious side effects.
Here's a more detailed description from the U.S. National Institutes of Health grant award. I think some doctors have been using these drugs already in "off-label" treatment to see if they help.
https://grantome.com/grant/NIH/R01-AG068324-01This project will be conducted [through] the Alzheimer's Clinical Trials Consortium (ACTC), ...supported by the National Institute on Aging (NIA)... The aim of this project is to test the efficacy of an oral combination of two cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD), for the treatment of agitation ...In the current proposal, we have chosen to use a combination of THC and CBD oils because of the enhanced synergistic effects that the combination can provide while maintaining a low side effects profile... A total daily dose of 8 mg of THC and 400 mg of CBD dissolved in digestible oil will be administered 2 times per day with a maximum of 4 mg of THC and 200 mg of CBD per dose. The study will recruit 150 HAAD subjects from 15 USA sites over a 2-year period. To facilitate recruitment and retention and to monitor long-term safety of the THC/CBD combination, completers of the double-blind study, will then have the option to participate in a 6-month, open-label extension study.
Your doctor may know if there's a similar trial in Australia. May you and she both find some respite from this delirium.
Nancy