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I started my Mom on a new med two nights ago (Trazodone 50mg) to help with her sleeping during the night, as she was awakening me many times during the night for about two weeks or so, thinking it was time to get up. A few times she would remark that her Mother had been with her, or her sister had come, (both deceased) but mostly it was just her mistaken belief that it was time to get up. I would escort her back to her bed, and she'd promise to stay there until morning. Of course it didn't happen. Thus, I called her Dr. for advice. He prescribed the 50mg. of Trazodone. I gave it to her at 9PM Thursday night. She slept until 5AM. I thought that was great progress. BUT, when I saw the condition she was in the following morning (yesterday) I was somewhat alarmed, as she was extremely confused, hallucinating, talking to people who weren't there, and not understanding that I couldn't see them, and off balance walking, and talking complete nonsense with scrambled words at times. She continued that way throughout the day. More confused and bizarre acting than I'd ever seen her act before. It was to the point that I felt unsettled to let her out of my sight too long. When I called the Dr. about this, I was told by his nurse (who didn't confer w/ the Dr. I might add) to just cut the dose in half. So, last evening, my Mom went from being rather fun and bubbly (still very confused and seeing people) around the dinner hour, to agitated, confrontational, and speaking about people being in the room with us, and why wouldn't we ask them to leave! She asked my husband who he was. She wouldn't stop talking. She was reluctant to take her Trazadone dose, and go to bed, when just a half prior she was all ready for bed. This confrontational behavior has never been present before. I had to really do some talking and cajoling to get her off to bed. She seemed very unsettled, still talking about this unseen man, who I told her was one of her guardian angels, hanging round to protect and guard over her. (this was 9PM) At 11:30, just as I turned my lights out, she began her up and down process, and it continued almost every half hour. At one point she had accidentally pushed the lock on her door, and I awakened with a start to our dog barking, as she pounded on the door to be let out!! I had to calmly talk her into unlocking her door, and when we finally got it open she burst out asking where all the people had gone who were yelling and being noisy in our living room. It was a freaky and unsettling night for all. Meanwhile I did some reading on Trazodone, dementia, behavioral issues, and I came upon an interesting piece regarding DELIRIUM. It sounded like what Mom is experiencing. Some meds mixed w/ others can cause delirium. (Mom is on Digoxin, and has A-fib. Trazodone can mess w/ heart rhythms, I read.) Delirium can be the result of an infection too. I'm wondering if Mom has a UTI. OR, and I guess this is my main question, could this very sudden strange and perplexing confrontational and agitated behavior be just a new phase of her dementia?? All of those things were listed on the serious side effects of Trazodone....but she's only taken two doses. 50mg the first night, and 25mg the second night. It's Saturday...so I really don't want to take her to the hospital for this, because there's a flu outbreak in town, and I don't want her sitting in an ER waiting room exposed to a bunch of germs. She is agitated, but I think I can keep things under control, just will mean no sleep. Should I STOP the Trazodone until I get things figured out? I am really confused as to what to do next. How dangerous is delirium, if that's what it is? Thanks for listening. Thanks ahead of time for any help. Braida

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Dementia itself can cause really disturbing behavior, and it doesn't have to come on gradually. But when there are sudden changes, especially involving hallucinations or delusions, it is always smart to check for other causes, such as a uti.

Seroquel was a wonder drug for us. I wonder what we would have done without it -- I'm pretty sure it would have meant a care center. But I also know that for some people with dementia it is neutral, and for others it makes things worse. Each brain is unique to start with and then is also individualized by the dementia damage. It can be very difficult but highly worthwhile to find just the right drug or combination of drugs for a given individual.

Braida, I hope you'll come back and let us know how things are working out. We care!
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Braida, I too, am going through exactly what you are with my Mom, except she is not on anything to make her sleep. I've seen some different actions from her over the past few days, but really in the past 2 days it has gotten really bad..........I know exactly where you are coming from with the lack of sleep and your brain not functioning well. My eyes burn and hurt from lack of sleep and I can hardly see to read and type..........I have put her to bed 15 times plus and it is only 2 am. Just getting ready to do it again as I type. She is seeing people, hallucinating, wanting to go to her Mom's so her Mom and Dad can take care of her (they have been dead for many, many years. Mom is 95) She was hunting for my husband's panties awhile ago, then a box of cakes and I had to get out from between the commode and bathtub. She got down in the floor with me trying to pick her up, but I got her over to her bed with a bar where she could hold on and I could lift her up...............I am worn to a frazzle and see a trip to the ER in the very near future. She is wandering around the house in total dark with only the light of my computer and the coffee pot light and microwave clock light. She has done weird things before, but this is the worst ever. I am hoping that someone can put some input into what might be wrong. A UTI, stroke symptoms or does dementia come to a peak and start down the other side and maybe she has reached it. Any thoughts, ideas or answer will be greatly appreciated. Thanks so much!
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Braida,
It often takes a period of trial and error to find the right med. Captain doesn't like seroquel. My mom has been taking it for two years and to me and other caregivers I know it is a miracle drug and works as it should. Mom started with 12.5 mg and has gradually increased to 75 mg. A few weeks ago I increased it to 100 mg because she was delusional and we are about due for an increase in dosage anyway. Then I decided to take her to the doc to check for a UTI, which of course was positive. After a few days on the antibiotic, I reduced the seroquel again and all is back to as normal as we can be around here. When we started seroquel doc said that he has some dementia patients on up to 400 mg a day.

good luck, I hope you find out that the cause could be due to a UTI which is much easier to deal with than the change you have seen the last few days.
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Melatonin is my med of choice because it is a naturally occurring hormone in the body. Most people tolerate it well.
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i just dont like trazadone cause of the skin crawl-y feeling, dry mouth and even palpitations. the only thing nastier imo is seroquel .
in reply to your question , yes , i think that the natural progression of dementia can result in phsycosis turning on one day with no prior warning. my mom became delusional about 2 months before her death and never really came out of it. the tranq , haldol , kept the agitation down but the paranoid delusions and hallucinations never stopped.
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Thanks for the helpful answers. Sometimes, with lack of sleep and too much worry, my brain stops functioning temporarily. Luckily it kicks back in. I KNEW, actually, before I even asked the question, that I wasn't going to give her anymore of that Traz. I was curious to know if anyone ever experienced a sudden onset of bizarre behavior like that just from dementia alone. But my gut feeling was telling me adverse reaction to the med. I called the clinic and got an immediate response from Dr. on call who said, STOP the med. She explained that elderly patients w/ dementia often respond differently to medication and can have the complete opposite reaction of what the drug is designed to do. This, obviously, was happening with Mom. It hyped her all up, instead of calming her. I asked the Dr. if I should try Lorazapan which I have in the house from long ago when Mom took it for anxiety, and she said it could do the same thing, and to take her off of everything, bring her in Monday, evaluate to see if there's a physical reason for this sudden never sleeping behavior, and start from scratch possibly with a different sleep aid drug. I'm inclined to try the Melatonin again, and stick with it for a longer period to see if it helps. Pharmaceuticals scare me. It seems they can lead to more problems than they fix. I guess one has to weigh the good against the bad. Thank you again for your input. Much appreciated.
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I edited my first paragraph and noticed I had taken out the main point -- if the Trazodone isn't working to help her sleep, there is no point of taking it. There are other options available that may work.
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The doctor was giving Trazodone to help your mother sleep through the night. It may be that starting the drug could have given your mother an overload of serotonin and the effect may subside as her body gets used to it. Perhaps the dose was too high, or perhaps it's not the best choice of drug for her. There are other medications to help people sleep, so it may be better to try another. I would talk to her doctor about it as soon as possible.

Anytime my parents have needed to go to the hospital, I have called 911 for an ambulance. It cost a little bit, but it bypasses triage. I've heard that the waits in the ER waiting room can be long on busy days. I don't want to put an elder or myself through that, particularly if the elder was not behaving rationally. That would be too difficult.

The onset of symptoms as soon as she started the Trazodone does make me believe the drug (or dosage) didn't agree with her. The doctor can check for a UTI and other things, but I would still suspect the drug. I hope you can get it sorted out and she goes back to normal, but sleeping through the night.
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STOP the Trazodone and call the MD ASAP. If he does not call back in one hour, call 911 and transport to the ER.
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