I am sorry you are having to deal with this. You will have to consult with your wife’s neurologist or Geri-psychiatrist, but our experience was that olanzapine (generic Zyprexa) was prescribed to treat delusions and anxiety. You probably know this but anti-psychotics often have black box warnings for patients with dementia and hose over age 65–that said, they’re frequently prescribed, off label, for dementia patients.

It was effective for my wife, though she continued to want to ‘go home’ and to see her long deceased mother. That said, she was eventually taken off of olanzapine due to its cumulative long term side effects. In my wife’s case, it affected her appetite, mobility and sleep.

I am cautious/ conservative when it comes to pharmacological solutions, but Alzheimer’s has taught me to do whatever it takes to ease my wife’s journey. Hope this is a successful route for you to go.

Andy, in your shoes I think I’d look to a pharmacological solution in order to keep your wife at home as long as possible. That’s my strategy.

When we dropped olanzapine, the neurologist increased the dosage for my wife’s anti-depressant. So far, this has worked for us to manage anxiety. I’m not sure about delusions as it has become more difficult for my wife to verbalize what’s on her mind.

My wife was on Olanzapine for sometime. My neurologist put her on it in an effort to control her sundowning. I don’t think it ever really helped. In fact I think it made her more restless. She seemed to want to keep moving- hands, feet whatever. She moved her hands as if typing or playing the piano. When she stood up she would move her feet like she was marching in place. The neurologist said that was a side effect of the Olanzapine. So she took her off. But she just told me to stop. So I did that, cold Turkey. But that was a big mistake. My wife ended up in the hospital for 10 days due to withdrawal effects. I recount this for your information. I think different people respond differently to anti-psychotic drugs. So it might not be a problem for everyone. But, based on my experience, side effects and withdrawal from them can be a major problem. So just watch closely. I know you will.
I hope you have better luck with Olanzapine.

Thanks, JF2 for your reply. My wife lost her mother when she was 8 years old and both of her brothers when they were teenagers...all to heart disease. So when she also says she wants to go "home" I think she means she wants to go back to when her mother and brothers were alive. Yes, I understand that with the anti-psychotic meds there are some wicked side effects. But on the trajectory she's on now, I fear I won't be able to keep her at home much longer; I've got to try something.
When your wife was taken off olanzapine, was it replaced with another drug?
Thanks again. --Andy

Thanks for your useful response, Hcook43