Another Seroquel Question

LaurieRZ

I'm so confused about this medication. I noticed several people on here mentioned their LOWD has been prescribed Seroquel. My mother was prescribed Zoloft, but I didn't notice any difference. When she was admitted to the hospital, they added Seroquel to her Zoloft to try and calm her since she was contantly trying to get out of bed. I messaged her Neurologist to update him about her hospital admission and med change and asked if she should continue the Seroquel when discharged. He said to stop Seroquel and increase the Zoloft. She went to rehab after the hospital and they told me their doctor was stopping the Seroquel, because there is a black box warning for Seroquel in the elderly and they shouldn't take it. I went home and googled this information and did see the black box warning. I then googled Seroquel for Alzheimers and it seems to be commonly used. My mom is currently in rehab, but they have placed her in the memory care unit while she is there.  The OT person told me today that my mother seemed a little more confused today and had her bags packed and wanted to leave. Wondering if it's because they stopped the Seroquel? I talked to the daughter of another lady there and she is on Seroquel. It is dangerous for the elderly to take Seroquel and if so, why is it used for elderly patients with Alzheimers?

Rick4407

Hello Laurie, I am not a pharmacist or a physician.  My DW has been on Seroquel for 3-4 years. She started with a very small dose 12mg and within a week or two upped to 25mg (the smallest pill).  She has further increased over the years to now 50mg two times a day.  She has had no problems with it and it has been very effective.  My understanding is that the black box warnings are associated with much higher doses (200-400mg) given to extreme psychotic cases in institutional settings.  I suggest you read here as many caregivers, particularly on the spouses forum, have had good results with Seroquel.   It seems to be particularly effective in late afternoon for sundowning. Rick

M1

good question Laurie; it's a tradeoff.  It can be a very effective medication in Alzheimer's with few short-term side effects, and the risk of cardiovascular events, though real, is fairly small (this is already a population with a high risk of cardiovascular disease).  Additionally, the doses used in Alzheimer's treatment are pretty low, on a relative scale---Seroquel can be dosed up to 800 mg/day in schizophrenia, and most Alzheimer's patinets are on doses of 12.5-200 mg.  

My partner takes it, 50 mg at bedtime, and it has been very effective for sleep fragmentation (the reason we started it) and beneficial for anti-anxiety effects too.  She takes it with Zoloft, Btw, no reason both can't be given.