Is there an alternative to Seroquel?

Beandsemom asked...

Even though my father was diagnosed in 2007 with dementia (probably vascular) he had been living at home with my mother and doing fairly well. Due to another health condition (spinal stenosis) he had to be admitted into the hospital. Since then his dementia condition has snowballed extremely fast and now appears to be in the late stages. My biggest issue is that he nursing home he is in does not seem to have staff appropriately trained in dealing with Alzheimer's and dementia patients. One night he started "hollering". They gave him Haldol (i think). The next night they gave him Seroquel. Medication reacts very oddly with him and that should have been noted in his chart. He is almost in a constant stupor and sleeps all the time. His doctor said they would hold off on the Seroquel but increase his Zoloft to 50 mg. He is still acting very odd. He is not in an Alzheimer's unit. Does anyone know of an alternative to Seroquel?

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

Seroquel and Haldol belong to the class of medications called antipsychotics. All these medications can cause stupor if they are used in high doses. It would be preferable to treat his possible depression by higher doses of Zoloft (50 mg is a minimal starting dose) and if necessary potentiate the effect of Zoloft by administration of Abilify. Abilify is also an antipsychotics but it was recently approved for combination with antipsychotics and is probably the least likely to cause sedation.

"Hollering" at night may be caused by a lack of activities during the day that would keep him from napping. He would benefit from being on an Alzheimer unit that would have an appropriate activity program.