Delusional episodes

5407mylh

My husband had a delusional episode last night that lasted about 2 hours. He was very suspicious of me and thought he was someplace else, I won’t bore you with all the details. This morning he didn’t remember it until I started telling him about it, then he remembered some of it. Is it normal for a person to remember all or part of an episode like that?

M1

Welcome to the forum Myth.  These things are very disturbing when they happen for the first time, and I think the question is whether it starts to repeat itself.  Could be the beginning of sundowning--time will tell.

My partner was very confused over the weekend--apparently from the stress of an outing as it has now resolved--and she was very upset by it, kind of realizing that she was more confused than usual (she forgot her sister's death for the first time and wanted to call her).  But now she's forgotten all about it.

A usual caveat is to think about other intervening illnesses--such as a UTI etc.--when there'a a change.

My partner tends to get upset when I challenge or correct her, so it may be the better part of valor not to try to discuss it with him too much.  My bet would be he won't remember.

Rick4407

My DW had several delusional episodes over the course of a week.  Her neurologist prescribed a very small dose of seroquel, 12.5 mg.   Over the course of the next 2 weeks we upped it to 25 mg - again in the afternoon.   That calmed her down considerably and eliminated the agitation.  Over the course of the last 2 we have slowly worked up to 3 doses of 25 mg each at 2 or 3 hour  intervals starting at 2 in the afternoon.    She has remained calm and though she has occasional delusions they do not cause her any agitation.  

You should probably raise the issue with his neurologist.  Rick

5407mylh

Thanks for responding, this is my first time on here and I’m a little unsure of how everything works. He is already on 50 mg of Seroquel at bedtime. The NP from palliative care thinks this is sun downing. He has gotten worse quickly and I’m feeling a little overwhelmed.

M1

Myth, I would definitely mention the incident to his docs an d ask them about increasing the Seroquel dose (and/or frequency).  50 mg isn't much and there's a lot of room to move up.

Rick4407

With seroquel timing is important.   The half life of the drug is 6 hours.  By the next morning he's down to very little left in his system.  By late afternoon its all gone from his system.  You may want to check with his neurologist, giving him the drug before he needs it may help you avoid the problem times.  Giving a smaller dose every 2-3 hours is bothersome, but not nearly the aggravation of my DW's delusions.  Rick

5407mylh

Thanks everyone, I have reached out to the palliative care team and they are planning to increase the medication at the next visit. Hopefully it will help