Drug Therapy

Love Matters

My Mom is in MC and has been aggressive, combative,exit seeking, won't let the caregivers help her bath, dress, won't let nurses examine her. Anyway, doctor prescribed seraquel 25mg and Ativan prn. She is definitely calmer but also less aware. I have researched these meds and also the alz meds such as aricept, namenda. Even though the seraquel has a scary black box caution on it the side effects are some the same with alz meds such as dizziness, solonence(sp?). I know the seraquel can cause sudden death, if course I don't want my Mom to die, she may die of heart attack from anxiety too? I don't know what to do. I feel like she must feel better not to be in so much distress all the time. I'm going to give it time and see if her body can get more use to these drugs. The staff tried to validate, redirect, and me too. Also tried to figure out if she was in pain which she can still tell me as she said her tongue hurt and she had thrush from antibiotics. Just needed to vent I guess, any thoughts are appreciated. What a hard journey this is. Mom is 92, had a good life up until this disease took hold. BTW, I'm there most days and the staff is wonderful to Mom.

terei

Many many PWD take these drugs.  Frankly, your mother is as the end of her life.  Would you rather have her spend it agitated + anxious or mostly calm albeit less alert?  

If I was in your mom’s place I would rather go from a heart attack than wither away with AD anyway.    It’s hard, I know, but we all die.  I would not spend a moment of worry about ‘black box warnings’

ninalu

Hi Love Matters,

It's wonderful that the staff in MC are so good to your mom.

Your thoughts & worries about Seroquel reminded me of my own when I was in your shoes - my mom was struggling with so many things all at once - anxiety, restlessness, suspiciousness, sleeplessness, fear - and the meds were new and I was the overwhelmed daughter trying to take it all in, help mom, protect her, learn everything fast. 

Others will reply as well with their experiences, too.

My mom's experience with Seroquel was overwhelmingly positive. It made a huge difference to her ability to have peace and engage with and enjoy other people. Her anxiety and day/night orientation was very difficult, and Seroquel virtually eliminated that. It also drastically reduced her fearfulness and suspicion of other people and their motives. For a time, she thought that we were all out to get her. It was awful for everyone involved. I think now, looking back, that the suspicion was a phase which Seroquel helped us through. 

Your mom is going through a tough experience and I very much hope that the medications being offered help her to find a better quality of life. In my mom's case, we gradually increased the dose, and then decreased, and then increased again. Your journey may be different. 

Thinking of you and your mom. Hoping that you find some ease from knowing that the meds can help a lot, even if they come with scary risks. 

MN Chickadee

Everyone reacts differently to drugs, and finding the right one to help our LO can take some trial and error. Work with the prescribing physician on dosage, sometimes a sweet spot can be found where they aren't too knocked out but calmer. Many, many people on these forums have their LO on Seroquel or other drugs of that class. They decide the benefits outweigh the risks; it's usually a last resort when quality of life is poor due to their distress or anger. Since the dementia is a terminal illness sometimes those risks make sense in order to give them the most of the time they have left.

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jfkoc

Ativan is known to have a fair amount of paradoxical reactions especially in older people. My husband was one who could not take it.

Teddy Peters

We had major problems with my 88 year old mother.  What we thought was sundowning morphed into her being filled with rage, making persistent mean phone calls, running away and getting lost, and angry outbursts that were almost scary. Already exhausted from being her caregiver, my days and nights were filled with dread.  Mom had been taking Venlafaxine for a few years.  But we clearly needed something more.  About 10 days ago, her doctor put her on Seroquel.  It has been a game changer.  She does seem to be more tired more often, which is fine.  I'll take resting mom over scary mom any day.  With the Venlafaxine in the morning and Seroquel at night, she is so much calmer.  We noticed the change after she'd been taking the Seroquel for about 4 days.  No more angry outbursts?  Wow, is this real?  Yep, so far so good.  Evenings are so much more pleasant.  Yes, she still has all the same serious cognitive impairments, but she is much more like her sweet, kind, and funny self.  For the first time in a long time, I feel like I am helping someone I love, as opposed to fending off a monster. Fingers crossed it stays this way for a while.