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Long time lurker-first time poster. Thank you to everyone that has helped me throughout this journey for the past 2 years that my Mom's health has been declining. She has been in and out of the hospital after a hot streak of no ER/hospital visits in 7 months! She was doing the UTI-Hospital-Rehab cycle for a year. I finally got her home and through this site was able to keep her well enough to stop the cycle. In January, her behavior started changing, and I thought UTI. She did have a bacterial infection and pneumonia. She came back home, but her symptoms (confusion/not being able to sleep or articulate a cohesive sentence, calling out for her sisters) continued. I also took her back in Feburary, and she was only there overnight because her test results(from CT scan/Xrays/blood work/UA) came back negative. She just came back last Monday 3/19 after a 4 day stay. She was on Risperidone 2mg for schizophrenia for 17 years, but they changed her medication to Quetiapine 25 mg at night and 25 mg in morning. Now for my question-She has an appointment with her psychiatrist on the 11th. The Quetiapine has been helping with sleep at night, but I gave it to her in the morning and it makes her very sleepy. I only have been giving it to her at night. After a week of being home and getting back into our routine she is having trouble eating/and speaking. She wont eat unless we feed her. Should I try the 25mg in morning also and see how that goes? Keep giving it to her at night only? Do 1/2 pill in the morning 12.5 mg and 25 mg at night? I posted this under dementia because the Dr's always say she has it, but I haven't noticed the symptoms. January was when she didn't "come back to me" like she usually does.

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Do call the doc. Seroquel makes you sleepy--well, it actually helps you go back to sleep when you wake up too frequently in the night. I take between 25-50 mgs at night only. I don't feel groggy or out of it next day. Just grateful I can fall back asleep b/c I wake up so much and have such violent dreams.

Can't believe a dr would just continue to prescribe this w/o seeing the patient. Sometimes we have to be our own advocates in our health care.
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Well, yes, the white car needs a contract, and you are going to take care of it in the morning, right? You are working on finding her another place to sleep, but for tonight this is the only room available. What can you do to make it more comfortable for her?

Does this kind of "going along" work with your mother? It often does in dementia, especially if the person is not likely to remember the discussion the next day. What generally doesn't work is arguing or trying to convince them. "We don't have a white car," or "This is your home now and it is where you always sleep," are just not going to calm Mom down.

We'd love to hear whether the Seroquel eventually is helpful, and what the psych doc does.
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I would call the psychiatrist for advice tomorrow.
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Thank you Midikid-I apologize the new medication was prescribed by her primary care doctor after following her at hospital and saw improvement. I see improvements, but not enough to be know what to do?
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Seroquel made my husband so sleepy I only gave it to him in the bedroom, after his pajamas were on. I had a very short window to work in! But as he was taking it for dementia agitation that was preventing him from sleeping that was perfect for us. Other people in my support group had differing reactions to that drug. Many were able to take it in the daytime.

That dosage seems very low for Schizophrenia. (Not that I am qualified to judge! Just from what I've read and heard from others.) This kind of drug often starts at a very low dose and builds up. Is her psychiatrist intending to gradually increase it?

I think you should contact the doctor with your question, either by leaving a phone message or using the patient portal if the clinic has one. You can discuss it at greater length at the appointment, but a quick question now is appropriate.

What doctors "always say" she has dementia? Based on what? Has she been tested? The symptoms "confusion/not being able to sleep or articulate a cohesive sentence, calling out for her sisters" could be UTI related, and they also could be related to dementia. Could they also be related to the underlying schizophrenia? I'm not familiar with those symptoms.

I am so glad you are having her see a psychiatrist. The next appointment would be a good time to discuss the possibility of dementia, and request testing if this doc thinks she has dementia and tests have not been done yet.

Since your mom has been treated for schizophrenia for 17 years I imagine you have been through a lot with her. Hang in there! Please come back and let us know how this progresses. We learn from each other.
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I was typing while others were. So the doctor prescribing the Seroquel is not a specialist in dementia or schizophrenia? Since the psychiatrist hasn't seen her recently and didn't prescribe the drug in question, I'm not sure contacting that doctor would be useful at this point. Definitely discuss it at the appointment! Meanwhile, contacting the prescribing doctor might be helpful. But plan on taking the pysch doc's recommendations after the appointment.
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Thank for your responses. I think I am just so tired of dealing with Doctors that I just wanted to get some ideas from actual caregivers.
-I emailed psychiatrist -but I doubt he will say anything until her appointment on April 11th since he hasn't seen her in 2 years
-I called the Dr's office (primary care) to ask the Dr. what to do. She was the one that changed her medication.
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It's funny you say that JoAnn; mom's discharge orders ALWAYS read "please follow up with your primary care physician as soon as possible".

In my view, the meds prescribed in the hospital were for THAT environment; sometimes the hospital's formulary was different than what was available outside of the hospital. Mom's docs almost always adjusted her meds after a hospitalization, but rarely to what the hospital had discharged her with. I never thought of that as being "the hospital doing something wrong"; it was more like "mom got sent to the hospital with an acute condition which was different from the stable one that she was in a week ago; there needs to be a change in meds, brought back to stability and, upon discharge, gotten back to her primary for a long term adjustment.
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Just wanted to update for future lurkers such as myself. The Dr. called and said that it can take anywhere from 4 to 6 weeks to get the full effect of a medication. She said to continue the dosage at night and in the morning if my Mom is agitated. I saw a small improvement tonight when I got home from work, but now she is saying that she is not sleeping here and that the white car needs a contract. I will update once we have the psychiatrist appointment in a few weeks and see what he thinks. I would like to get off this roller coaster ride now thanks!
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Just wanted to post an update.

Saw the psychiatrist today and he said to do 12.5 mg in the morning and 12.5 mg at 1:00PM and then the 25 mg at bedtime.
He also said I should look for placement for her because she is only going to get worse. I think I will ask the home health nurse for a hospice evaluation. I am not looking to "fix" anything at this point, I just want my Mom comfortable and at peace at home.
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