Seroquel(9)

Gig Harbor

My husband had an appointment with his PCP who he has only seen once. I went in early and dropped off a short note explaining that he was starting to have anxiety and delusions most afternoons thinking he was at work and needed to fix something. He would get mad when I didn’t know how to help him. I asked if he should use Seroquel, Ativan or CBD with THC. He suggested 25 mg of Seroquel with a check back in a month. I just got a notice from the pharmacy that the prescription is ready and it will be $1.18. I hope it works because I can’t beat the price. Of course today he has had no issues.

60 falcon

That certainly sounds like good news.

Is Seroquel something that is commonly prescribed by a PCP?  The reason I'm asking is because I've been trying to get my wife an appt with a psychiatrist for almost 3 months to hopefully get meds for delusions and agitation.  I've been working through her PCP (Physicians Asst.) who's been putting in referrals to this psychiatrist and things keep getting messed up.  Maybe I should just ask her to prescribe it?

I hope it works for your husband too. Wouldn't it be nice if more meds were that cheap.

Gig Harbor

When our neurologist left the practice she suggested asking our PCP if he were comfortable ordering meds for dementia and especially when symptoms began to progress. He said he was and has refilled the aricept and namenda. As he said today there are not really a lot of different meds to try and we do need to try the seroquel to see if it will work for him. I appreciate him because it is hard to see a geriatric psychiatrist or a neurologist. She might be willing to give your wife a prescription to try and she can run it by the physician she is working under.

Joe C.

Gig, Seroquil worked wonders for DW. One thing to be aware of is you might have to tweak the dosage in the beginning and then from time to time in the future. When I gave DW 25 mg the first time it really knocked her out, so I had to cut the pills in half and give her 12.5 mg in the AM & PM. It takes 4 to 6 weeks to really see the benefits of the medication. After tweeking the dosage with her neurologist permission, at the end of about 6 weeks I wounded up with 12.5 mg three tomes a day (morning, afternoon & evening).

Rescue mom

60falcon, and gig..  DHs PCP, neurologist and other docs refused to give an Rx for Seroquel, said state laws prevented it, and that Rx had to come from psychiatrist.

I know the Rxs for pain meds are so regulated in FL., but the Seroquel caught me by surprise.

It took a couple months, to see the geriatric psychiatrist we were referred to, or any other I  call. Other docs later told me that Rx restriction is true for usage of more than 3? days and no doc around here would write it, only psychs would.

 The bottom line for us was/is, whether law or not, other docs would not do it.

For Gig and others just  fyi, like Joe, the initial 50 dose was way too high for my DH and totally knocked him out for 12-14 hours. Then I cut them in half, and he still just slept, although not as long. Still tweaking, but the delusions that were the initial problem seem to have quit. 

And yes, it’s extremely inexpensive as meds go, although at this rate 30 days worth is going to last a while….

Gig Harbor

Well one hour after 25 mg of Seroquel he is very confused. I don’t think we will try another dose. He is actually having trouble moving. It is such a horrible disease when you watch your LO so lost and unable to do simple things.

Joe C.

Gig, Seroquil is a medication that you need to give some time to see the effects/benefits. As I said in my post above when I gave DW her first dose of 25 mg it really knocked her out, she was almost comatose for about a 1/2 hour. Cutting the pills in half had a less dramatic effect and just made her a little drowsy. In a relatively short time as her system acclimated to the medication she would just get real calm for an hour or so after taking the Seroquil. The ultimate benefits of the medication far outweighed my initial concerns when she was adjusting to it.

M1

GH try giving it at bedtime only at first, that would be my suggestion.  I guess it varies from state to state; our PCP prescribed it and I prescribed it myself when I was in practice.  Partly depends on what the provider is used to using.  FL is the first I've heard of state restrictions, I'm going to investigate a bit.

Lynne D

What a variety of reactions your loved ones have had. I only wish my husband’s geriatrician paid attention to things like this.

My HWD has been experiencing increased agitation, and his palliative care doctor, who is a geriatrician, will not prescribe anti-psychotics because of the side effects. The agitation had increased to the point of him shoving me when I suggested he brush his teeth. I feel like I am living in a house with a madman.

I thought about taking him to a psychiatrist (ya, behind his doctor’s back) but now I don’t know what I need to do.

That being said, drugs may not be the answer at all…

Gig Harbor

By the time 4 hours had passed ( with an hour long nap) he was back to normal. He sleeps all night so I don’t want to interfere with that. He literally had trouble standing up. There is a new compounding pharmacy in our town that has a pot shop connected with it. I thought I would stop in today and talk to the pharmacist. I think that if he were in memory care right now this might now be as big an issue. If there was activity around him and more people to talk to I think he would be distracted and possibly happier. Being home with just me gives him too much time to get involved in his mind. I just can’t be a social director all day trying to distract him. We can only do so many drives and stops for milkshakes. I know that at some point he will move to memory care but I hate to do it too soon, both for him and the $7500 a month. Each week when I fill his pill box I think to myself I just saved $1900 and I ask if it would have been worth that amount to have him in memory care. Each week the answer is no. I will know it is time when I say absolutely yes.

Gig Harbor

Maybe I will try cutting the pill in half. Now that I know what it can do I will plan to have him sit down during the first hour if possible. Thanks for your input.

shardy

I only give seroquel to Jim at night.

 It makes a BIG difference in his anger and agitation, and his overall attitude becomes more pleasant. 

It takes roughly 2 weeks to show full effect in him but, I can usually see improvement after an increase in only 3 days. 

We have increased it every 6-9 months as needed. I couldn't have him at home without it.

Rescue mom

M1 I know this is going to be a hard exhausting day for you. I’ve thought about you so much. Some similars, and this is undoubtedly sooner for me than I think. You have helped us all, pretty sure about that, on this experience we deal with

Your Seroquel comments made me a bit more curious about FL state law(s) regarding Seroquel Rxs. I didn’t think much about it b/c docs here cannot, by state law, do Rx for ongoing pain relief with certain drugs. But those laws are now in many other states. I just assumed Seroquel fell in that most-regulated —by the state, mind you, not the doctors—drug classification.

I also wondered if the refusal was an “office” (ownership) decision.  Our area is unusual in how all the hospitals have the same owner, and most docs work for one or two big corporations/owners. My gastro doc, who’s been practicing here 40 years, said he can count on two hands the independent docs remaining.

Regardless, there was unanimous refusal from the 6-8 docs I contacted to write the Rx, all said it had to be done by a geriatric psychiatrist. So. That’s all I got.

Gig, the psych who gave DH the Rx said he should start with it at night, right before bed. And it did knock him right out. Obviously others here have different experiences, which is all good to know IMO. 

Gig Harbor

RescueMom,

Do you give Seroquel to your husband earlier in the day now? My husband sleeps well at night. His bad time now starts between 3-4. He is not angry just very convinced that the phones are not working and that he has to fix them. He keeps wanting me to help him. He is 83 and already went for a 5 mile walk today and mowed the lawn after I set everything up. I am exhausted and he is raring to go. I have thought about giving him 12.5mg of Seroquel but his response was horrible last night with 25mg. He couldn’t stand up or talk.

Riz

Hello, I am new to the message boards but have been helped by occasionally reading everyone's posts.  My DH was put into MC 2 months ago because of his aggression.  He started out with Seroquel. It knocked him out for the first couple of days and then he just started to metabolize it better. He was on Seroquel for about 5-6 months but eventually I had to change to another drug as it stopped working as well.  It almost seemed as if it were making him more aggressive.  Anyhow, he is on holoperidol, which seems to work better for him. 

extex

My wife has been on seroquel ( prescribed by her PCP) for sundowning.  Her sundowning begins  around 3:30-4:00 pm.  When it begins, here comes the seroquel.  I start with 25 mg.  If she doesn’t calm her down within an hour I give her 25 more.  The first 25 usually works and she is ready for bed about 6:30.  She sleeps all night most nights but occasionally has a midnight episode.  Then she gets 25 mg more.   Her doc is ok with this and it helps so very much every day.  Maybe important, I prepare her dinner immediately following the first seroquel pill.

Tony484

After a very difficult month of heartbreaking anxiety, DW's PCP tried Seroquel and gradually increased the dose to 150 mg, with 50 in am and 100 in pm, in order to minimize daytime side effects. The positive effects have been remarkable, with the most serious agitation and anxiety mostly gone (though still plenty of low level anxiety if I'm not directing activities).  No negative side effects to speak of.  Doc says there is one other med that, as a PCP, she feels comfortable prescribing, but after that she would refer to a psychiatrist for other drugs.  Also, apparently the 150 mg daily dose of Seroquel gives some room for further upward adjustment. So far, the Seroquel has been a huge blessing.