Is Seroquel safe for an elderly dementia patient?
My mother (89) has dementia (CT scans reveal blood vessel shut down and atrophied brain). Lately, she will go a couple of days without sleep which is murder on the caregivers who must attend to her. She has had several falls and is at extreme risk for falling. The caregivers follow her around the house at all times which is sometimes like following the Energizer Bunny. She is confused and delusional and is often looking for the people in her life...my deceased father, her mother, her sister, her cousins, people all long gone. At night she gets the munchies and will raid the refrigerator, have a loose BM at 2 AM (sometimes before making it to the bathroom) then will finally go to bed but even then may not go to sleep. Of course, the caregivers get no sleep not to mention having the unpleasant task of cleaning up mom in the middle of the night. What should we do? She is taking Aricept, Namenda, Zoloft, and Remeron (and Ativan as needed, typically around 5 PM for agitation). We have been conservative with drugs because the side effects all seem to indicate drowsiness, and with her risk for falling we don't want to add to her feebleness. How can we get her to sleep peacefully at night? I've heard about Seroquel, but information on the Internet is full of dire warnings for the elderly with warnings of possible death. How safe is Seroquel? We are worried that she will still get up in the middle of the night, groggy, disoriented, and wobbly on her feet.
This is a difficult situation but I would not recommend adding Seroquel to her medications. It is difficult to find an effective dose without side-effects with it. If you are afraid of falling, I would try to eliminate Ativan, because it increases greatly the risk of falling. It would be better to try to deal with your mother's agitation by behavioral strategies, e.g., trying to keep her occupied. I wonder if she is getting her Aricept in the morning. If she gets it in the evening that may cause nightmare and disturb her sleep. I would recommend replacing Remeron by Trazodone given in the evening. It is also an antidepressant and it promotes sleep better than Remeron.
I am so grateful for the expert answer from Dr. Volicer. Information from doctors who specialize in dementia is difficult to find. My mother's internist and psychiatrist are extrememly knowledgable and capable, but I sometimes feel they lack practical experience with the dementia patient. Many thanks for your time and advice. By the way, my mother takes 10 mg of Aricept, and we were advised to break it up, giving her 5 mg in the morning and 5 mg in the evening with dinner. I had read somewhere else that it should all be taken in the morning. We will try this, and I will suggest Trazodone as a replacement for Remeron to my mother's doctor. Thanks again.
I have read to give the Aricept at night..His Dr says to give it in the morning..but he sleeps so late due to being up at night, that i can't give it in the morning usually.. This disease is so complex that i am not sure anyone knows what to do..My Husband takes Aricept, Namenda 10 MG each, blood pressure meds and plavix, and resperidone..I wonder about this combination..pharmacy doesn't say anything and Dr don't either..Neuro says that PCP is doing what he would do..but i read all these things about these antipsycotic drugs..................I am no Dr but sometimes i feel like i almost have to be..
Giving Aricept in the evening may cause nightmares and sleeping problems. If your husband is not having delusions or hallucinating, Risperidone may not be appropriate and he may benefit from an antidepressant.
I am a caregiver and would recommend Trazadone over Ambien, Resperidone or Seroquel. I have taken all three myself for sleep and Trazadone is by far the most effective and also helps with some problems associated with dementia and Alzheimer's. I would also HIGHLY recommend adding organic extra virgin coconut oil to the persons diet, working up to 4 teaspoons a day. This honestly works miracles with Alzheimer's and dementia. Google it and read about it, but trust me, it's amazing stuff. Also rubbed in skin folds, will get rid of yeast infections in a day or so! :)
The doctor is right on in his advice! It is soooooo very difficult to get the correct drug cocktail, and you don't want to sedate your loved one....'.although, many have to be sedated to protect themselves FROM themselves and others ....all of this could be avoided if one has a specialist in the geriatric field....specifically dealing with dementia.....
My mother is 96 and has dementia. We have given her all of the drugs above for sleep and delusions. She does take the Aricept and Nemenda for her dementia. My sister and I are her caregivers. To make a really long story short we started her on 25mg of Serquoel. For our situation it has been a miracle drug for us and my sweet mom. We use it every night about 45 minutes before bed time. My mom is so much happier now. We have had very little side effects, but have had to increase the dose, as it stops having the desired outcome. I know of all the FDA warnings. You have do what you think is right for your loved one. If my mom died today I would not regret helping her get past all the awful delusions she was having. They really frightened her.
Yes, my father who is 90 and post a hemorrhagic stroke is home living with us. He was not sleeping and calling out for people in the middle of the night all night long. The MD ordered Ambien which mad it worse. We switched over to Seroquel 50mg at bedtime. That worked for about two nights then I had to increase to 75mg. This is working pretty well. He is combative during the day and I wish I could give him a mild sedative. His caregivers are great with him and I too would do this again if needed. No sleep for the whole house is a nightmare!!!
I would agree about the Seroquel. My mom is 79 and recently diagnosed with Alzheimer's Dementia. She has exhibited symptoms for a while, but just got diagnosis. We had to take her off Ambien and Xanax (which she had taken far too long). Even with Depakote, Namenda and Ativan, was NOT sleeping AT ALL. My dad (80 but in GREAT health) went 4 days with no sleep, as well as us. We put her on 50 of Seroquel and it has been like a miracle. She was having multiple nights in a row with delusions and little to no sleep. She still is confused and had the occasional delusions, BUT she is less delusional, pleasant with some confusion during day and sleeps 6-8 hours at least most nights only getting up for bathroom a couple of times. Occasional bad nights, but NOTHING like before the seroquel. At almost 80, We are Looking for Quality vs Quantity!! She is much happier (and so are we with her sleeping at night and only occasional daytime nap).