Seroquel drug for dementia person's angry behavior in an assisted living facility?

PS Anti anxiety medication will not only make her tired, it will make her unsteady on her feed (if she walks) , and it constipated my Mom so badly she became impacted. IF they do use it, give 3/4 teas of miralax daily, or whatever your dr says. I've been that route too, its not a good thing, its devastating when they are constipated. My Mom has prune pudding with her pills and 3/4 teaspoon of miralax every morning to keep her bm's soft. Its trial and error until you get the right dose.

Marie, the head of neurology even told me no seraquel for my Mom due to her dementia, and they put her on depakote sprinkles, works fabulous! My Mom also always had negative urine cultures yet the dr treated her anyway and that also worked because, even on depakote, she started hallucinating 2 weeks ago, I did a week of amoxicillin after a long talk with the doctor to please treat tojust see what happens, and she is back to normal. Push Those Doctors!!! You have to!!!! Ask for depakote please and know you are a great daughter, no matter what day it is!!
(((hugs)))

MARIE:

It's a lot easier to dope somebody up than to take the time to find the underlying roots of the problem. Triggers identified, you can formulate a treatment plan that includes both natural remedies and Rx medications.

Seroquel might alleviate -- if not mask -- the symptoms and help her relax, but what do you do when the effects wear off?

Thank you both for your insight and encouragement! Her blood work & urine spec. came back negative. The first week she was on the upped amt of Seroquel wasn't bad, but now maybe it's accumulated. The staying in bed all day started after the increased amt. She's having some trouble swallowing her all of pills too; previously could toss back 5 at a time.

I'm hoping to talk to her dr on Monday, and see if I can get her into a gerontologist that specializes in AD/dementia asap. But before that, I'm going to halve her 6PM dose, or I'll never even get her a much needed shower! I feel so bad for her, but glad she's unaware of just how much she's changed. Two years ago she was on Celexa for anxiety, but it eventually backfired; hence Seroquel.

Thanks again, I know my husband & I will work out some time with our extended families...just had a tough moment! ;-) Merry Christmas to you & yours! ♥

CajeanL50, I am truly sorry about how you are spending Christmas weekend. Hugs to you as you deal with these challenges.

Your mother's new levels of agitation, sleepiness, etc. could be a result of the drugs she is taking. This started, I understand, before the increase in the Seroquel, so presumably it is not totally a result of the increased dose. How long will it be before you can consult her doctor? Is there a nurse line provided by her clinic or insurance that you could call and discuss the situation with? I don't think that this is a drug you should stop cold turkey, but a knowledgable source may be able to advise you about a reduction until you can talk to her doctor.

The changes in her behavior could be related to something else that is going on in her body, such as a uti or low level infection of some kind.

And the changes could be the progression of her dementia. Dementia by its nature gets worse over time. Perhaps that is why the doctor is trying a higher dose of something that seems to have been working well.

Diseases of the mind are extremely hard to manage. And we all feel so helpless when our loved ones are suffering and we don't know what to do. Ultimately the disease will win. The goal is to maintain as much quality of life as long as we can, and to optimize comfort and minimize distress. Know that you are doing your best.

I hope that you can talk to a medical professional now, and to see her doctor soon.

Sit in her room, hold her hand, enjoy some holiday music together. Again, hugs to you.

please read user reviews of this drug. I is NOT recommended for dementia patients. NOT NOT NOT. I was at the same place...using it for awhile, worked fine, then it backfired. The temptation is for the caregiver and doctor to UP the dose. Please, ask if you can try her without for a few weeks. Watch for choking, muscle stiffness, body stiffness or slumping. With this drug you may have to get her off it gradually. Please research. You will notice users of this drug are bipolar, and the doses they take are HUGE by comparison. I think we were on half pill, 12.5 mg day, and mom still had a lot of trouble. I actually figured she was dying at her worse point.

If your doctor does not know what Beers Criteria is...get another doctor. it is the protocol for getting the elderly off drugs, getting long-lasting versions rather than quick acting, etc. Mom actually did not need this drug in the first place, in retrospect. She just did not understand her GERD symptoms and was delusional she was dying...felt like heart problem. Unfortunately, the doctor replaced with Ativan, and that caused other problems. Eventually, we got her off every single med and she has no hallucinations nor delusions. Live and learn, at Mom's expense...and tough caregiver job.

Hang in there...

My 90 yr old mom (w/ dementia) has been on 1 Seroquel (25mg) a day for about a year & a half; she took off once when my dad (now late) was in hosp. Worked like a charm; no obvious side effects.

Recently she began exhibiting much anxiety, agitation, sneaking outside, hearing voices telling terrible stories, seeing awful things, talking to herself all night, etc... So the dr added one more Seroquel at 6 pm, and the other at bedtime...however bedtime (a week later) is earlier, like 8pm. It's increasingly hard to get her out of bed, or out of her room, not dressing, no interest in anything but looking out the window. Isn't hungry, getting harder to get her to eat anything, "It tastes bad!", will hardly drink water, weak & tired, constipated some, just wants to lay down all the time.

So here I am, Christmas weekend...looks like I'll stay home to monitor her. I wanted to get her shower, but it's not looking likely! I'd like to cut back on this even before contacting her dr. Any more thoughts from y'all? Such a rotten disease!

From the discussion board on the Lewy Body Dementia Association site, it seems that it is frequently prescribed for that disease. Sometimes it doesn't work, and a smart doctor then discontinues it. Sometimes it works a treat, as it does for my husband. Sometimes it works great for a while and then doesn't.

I think factors that need to be considered is how serious are the behviors that are being treated and what are the alternatives? Are there potential remedies with less risk? Have they been tried? If you have simple depression (not, for example, bi-polar disease) there are certainly other things to try without resorting to such a powerful drug. The same is true of typical insomnia.

I gues all of this is pointing to the importance of dealing with a doctor who understands the particular conditions he or she is trying to treat, and understands the risks and benefits of any drug being considered.

Yes, Jeanne, I think you are right that according to our current understanding there are a few cases when a drug like Seroquel can possibly help. I'd emphasize that these cases are few, and this drug is definitely overprescribed. A doctor almost gave it to my mother for sleep. A nurse practitioner tried to prescribe it to me for depression. That's when I stood up and left her office. I think we need to use the greatest possible caution in using the drug. I consider it a poison, but other medicines can also be poisons that can still work for us in small doses.

And I have to pop in again and repeat that I am truly grateful for the small dose of Seroquel my husband has been taking daily for 8+ years, prescribed by an internationally known dementia expert (behavioral neurologist) at the Mayo clinic. Definitely this is a strong drug and should not be handed out willy nilly. But in the right hands, it can be a godsend. I would "never" allow my mother to take it, nor would I take it myself, if prescribed by an internist or anyone but a specialist who knows the disease, knows the drug, starts with a small dose, and monitors the results carefully. I understand how some of you can be dead set against this powerful drug. I just don't want to see the baby thrown out with the bathwater.

Antipsychotics in general may be overprescribed, especially in nursing homes. That does not mean they are never justified and never the best choice.

It is generally advised that elderly dementia patients not be prescribed this kind of drug. I can't quote facts or studies on why, but I believe it's part of the warning label. I think these are very dangerous drugs for anyone, so I'll let you know that as my disclaimer before I make my comment. My 85-year-old mother was prescribed Seroquel (after Abilify) and I think both were disastrous for her. A real zombie effect and long-lasting if not permanent neurological damage (tardive dyskinesia, Parkinsonism). As her caretaker I also felt I observed MORE psychosis, not LESS. After years of experience with these drugs, I believe they are another blind alley on the psychiatric professional journey. A couple of studies have shown that there is no long-term reduction in psychosis or improved outcomes even in schizophrenia. I think some day we will come to our senses and stop using these drugs. Meanwhile a lot of people, even children, are being damaged. That is my candid opinion. I would never allow my mother to take a drug like that again.

My Moms neurologist told me that it accerates death right and he did NOT want to prescribe it to dememtia patients, thats why he recommends Depakote, its safer. Its called a Black Label I heard, not for them and has a high death warning on them. I am so sorry for your Fathers passing.

I am a physician, currently suing a nursing home for giving my father with Alzheimer's Seroquel which is obvious to me accelerated his death. DO NOT GIVE THIS MED'N TO PEOPLE WITH DEMENTIA!

My 94 year old Mother with "at least mid-stage dementia", not Lewy Body, takes 100 mg Seroquel at bedtime as a sedative, and was on additional 25mg divided throughout the day for her irritable personality which now they call "agitation".
I'm not sure what they called it when she was in her 30-40's when I was first
exposed to it, but It's about the same behavior except she doesn't threaten us
anymore. Psychiatrist prescribed Celexa, an anti depressant, for use during the
day to try to wean off Seroquel. I have noticed an involuntary twitch that I read
was a side effect of Seroquel. Mother's Geri psych says it is effective in the lower
doses. Psychotics are prescribed 300mg and up! The doses given elderly are very low! (God please have mercy on us.) hugs, Christina

My husband (Lewy Body Dementia, 85) has taken Seroquel for almost 8 years. I would hate to be without it. It is THE drug that made it possible for me to keep him at home. In his case, he takes it only at night and it addresses nighttime agitation. It was prescribed by a leading, internationally respected sleep psychiatrist and approved by an equally well-respected Mayo Clinic researcher/behavioral neurologist. It has been highly effective, with no change in dose or side effects the entire time he has taken it.

My bipolar brother also takes Seroquel, also as a pre-bedtime medication.

I have also heard from other CGs whose loved ones have the same diagnosis as my husband that Seroquel was not effective, or that it even made matters worse (which stopping the drug solved.) When treating disorders, ESPECIALLY problems in the BRAIN, what works magic for one is a nightmare for someone else.

I would ask, how qualified is the doctor you are dealing with to treat the condition your loved one has? Can you get a second opionion from a specialist if that is appropriate? Is the doctor going to start with a very small dose and instruct you what to watch for by way of side effects and effectiveness? Is he or she going to approach this as a "trial period" and be willing to stop it and try something else?

WIth any drug there is a risk it won't work or it will temporarily make matters worse. And it is true that some LTC places overmedicate for their own convenience. For this reason some people shy away from drugs. I am a huge fan of drug treatments, carefully thought out and slowly, watchfully administered. Better living through chemistry is my motto! :) I saw what my husband was like without drugs, and what a huge positive difference they have made in our lives.

Be cautious, Sunshine. But also be brave!

Tried that, it made her nutty and aggitated. Depakote works wonders and is safe, its for seizures (but she dosentt have them). Seroquel is dangerous and only to be used as a last resort my moms neuro said. good luck

Are anyone's parents with dementia actively on seroquel and if so, how are they doing?

My mom was on ativan 0.5 mg for anxiety and ristrral for sleep i t was 10 mg. that seemed to work for I don't reccomend seriquierr for demsia alz. My 1 frind was on this she died her dr over medicated her. I cn'a beleave some of Drs they need to recall this drug. . my friend mother is sueing the Drs who over medicated my friend.

I don't reccomend serquiel my best frind died 2 yrs ago from this mediation she was 49 yrs old she was in a psych unit. the Drs at this hospital over medicated my friend. sje didn't have alzhemers. she was manic depressive.. please i urge you don't let your love take this medication.

According to my moms neurologist, its the LASTchoice because it causes heart attacks and strokes. depakote is what he recommends and works like a charm, its an antiseizure med but works.

Should an elderly patient diagnosed with vascular dementia be taking Seroquel?

In response to luvmom - I hate to repeat myself but Seroquel IS a fabulous drug when given to the right person at the right dose. Please read the whole sentence before you start chuckling. And as for the highest probability of stroke or massive heart heart attack...as compared to what??? I think an injection of powdered Depakote straight into the aorta would probably have a higher probability of stroke or massive heart attack than a carefully prescribed & monitored minimal dose of Seroquel. You might also note that Depakote has a lovely long list of severe possible side effects like liver failure for one. Depakote is actually an anti-seizure drug, also used as a mood stabiliser, so it's probably a little unwise to compare them in such general terms.

Anyway, the point was, all drugs have the potential for nasty side effects, especially drugs that alter brain chemistry. However, when someone starts to exhibit angry, confrontational behaviour, it can be very distressing not only for the people around that behaviour, but also for the person exhibiting that behaviour. People with dementia may well be aware that their behaviour is changing & may be embarrassed & ashamed of their inability to control their behaviour.

Unfortunately, using anti-psychotic drugs, mood stabilisers, anti-depressants etc, can be a bit of a gamble. There is not a lot known about how these drugs work, but we do know that they DO work...not for everyone, but they DO work. Sometimes it's a matter of trying a few different ones until the right one is discovered. It's not a very precise science.

If you're going to go down this road, just be sure that your mom is carefully monitored for changes in her mood, behaviour, also blood pressure, other vital signs, relevent blood tests (for example, liver function needs to be monitored with Depakote) & you need to be able to trust the doctor. If not, get a second opinion. Also, be sure that other methods of behaviour management should have been tried before going down the medication road. Ask the facility what they have tried. If you haven't already, perhaps get in touch with a dementia support group to see if you can get some education about behaviour management in dementia care.

Good luck

I do have to chuckle in shock when I read that "Seraquel is a fabulous drug" when its black marked with the highest probability of stroke or massive heart attack. Depakote is safer by far according to my Moms Neurologist and doesnt recommend seraquel unless its a desperate situation. Dont get me wrong, I prefer no drugs but I do agree with the last comment, dont believe what you read on the internet, including here.

Addition of new drugs in the elderly should always be carefully monitored. Seroquel is a fabulous drug when given to the right person in the right dose. Unfortunately, like a lot of psych drugs it does not suit everyone & it is nigh on impossible to tell who it will work with until you try it. The extrapyramidal side effects that people are describing on this thread are a bad side effect. The drug should be stopped immediately if these occur. Also Seroquel anger is an increasingly researched side effect that should result in discontinuation. Seroquel is worth a try as it generally has less side effects than the older antipsychotic drugs, but again, use with extreme caution. Monitor for side effects & speak to your prescriber if side effects occur. If you do not get a satisfactory explanation from your prescriber, tell them you are not satisfied. Tell them you are worried about your mother. Tell them you do not understand. Get a second opinion from another health proessional. And do not believe everything you read on the internet unless it is from well respected peer-reviewed publications. People who relate personal experiences on the internet are more often than not highly emotional about their bad experiences & do not give a well-balanced account of the facts.

Marie,
Please be careful with the Depakote, I've taken both for PTSD and I would not recommend either. But....I don't know what dose your mother will be taking, her health status or how old she is. If she needs to gain weight it will take care of that.... and some people lose a lot of their hair (I didn't though).

God Bless

On the depakote, if you get it, ask for the sprinkle capsules. You can put it on their food if you want. I crush all of my mothers medications mixing them in a tiny shot glass with a couple of teaspoons of Prune Pudding that I make. (This keeps her more regular in the bm department also). They WILL sleep MORE at first, but that goes away so hang in there. Its not an antipsycotic , its an anti seizure medication and the first line of defense Her neurologst told me before trying drugs like seroquel that have been proven to cause problems in the elderly. I find when the drugs are all crushed (check with your Dr first because I had to change some of her meds that couldnt be crushed) I can get them into her quickly I start to tell her a little story, "say ahhhhh Mom" , put the spoon in quick, and finish the litlte story, it goes well. Ahhhh the tricks we use huh? Does anyone else feel trapped inside today? Sometimes it sure gets to me.

Oh, if you want to just make them sleepy, you could try Benedryl, the allergy OTC med. The Tylenol PM has Benedryl as the sleep inducing part. When we were getting Mom off Ativan,the doctor said that was much better solution to get Mom to sleep during the night. We used it a few times. For awhile, between Seroquel and Ativan, we doubled Mom's Zoloft, as that may have a calming effect.

But you know what, they (doctors) don't done KNOW nuttin about all this. It seems to be a big crapshoot, with our parents as the guinea pigs and "there are no medications without side effects" and"part of normal Alzheimer's decline" as their impunity shield.

As much as I eventually decided to X the Ativan, it could be useful for knocking back weird behavior once the patients starts on a rant. the pills are so small, that a half a pill would do a lot, even quarter.

I at first assumed I should use it regularly to stop attacks before they even began, and dished it out a half pill at bedtime, and a quarter in AM. And for awhile it quelled outbursts. And then and then and then...

Just to let you know that this Ativan can take effect in about a half hour. My ER intake-desk nurse niece said that they used Ativan to calm relatives who had someone die in the ER.

However, if the patient is already upset, good luck getting any kind of pill or food down them. I keep it on hand just in case, and darn if there is now no "case." for now...who knows what the next day will bring.

Glad to know about Depakote. There was a funny (written in joking style) report about the side effects of that drug on one of the reporting sites. Said it would make you an instant elderly person. Would of course read up on it totally before I had mom get on it.

Do you have a Plan B?

The comments I've read have been very helpful. I was up at 4:00 this AM,reading all. I decided not to continue with the Seroquel after seeing what it has done to my husband during the last two days!

Hello all, I also had problems with my Mom getting agressive after her strokes. She was taking off up the road beating up my am caretaker and that did it for us. She got so agressive and nasty, so unlike her! She also has alzheimers. The Neuro recommended Depakote and it works great. He recommended 4 a day (125mg) but I only keep her on 2 a day. (sprinkle capsules) We stil sometimes have the sundowners of her trying to get out of the house, or daycare, but it STOPS agression in its tracks without side effects. Her Neuro said its a safer commonly prescribed drug used in nursing homes and the daycare personel tell me most are on it. It lets us keep our parents at home, or happier .They dont want to be like that, they cant help it. I hope this will help someone else.