Sundowning and Seroquel

FloydSnax

Many of you know about this hour that takes place that turns everything upside down. For my mom, everything is manageable (her behavior) until 4pm comes around. A kind member here had told me of a drug specifically made for this behavior called Seroquel. Why her doctors had never mentioned this to me...I don't know. But I (my mom) just happened to have had an appointment a few days after I gained this knowledge, so I went in there with high hopes.

I was under the assumption that at my 4pm, something could be given to ease or eliminate this behavior. Her doctor kind of switched it to a sleep at night deal/aid. My mom doesn't have a problem with sleep. She has a problem at 4pm. 

So, I researched Seroquel, and it sounded kind of hard core as a total psychotic, schizophrenia med, but that's how I would describe her behavior at every 4pm....so.... Maybe it's the type of drug that works on that behavior over time. She was on Tazadone and we're weening her off of that and increasing the Seroquel to eventually eliminate the Trazadone. I hope that's the case.

I bring this here because this site has helped me throughout this entire ordeal immensely and maybe someone reading this (going thru the same crap) might get some help somehow. I will keep writing down everything and keep you informed. Every comment welcomed. Thank you.    

live in daughter

Hi Floyd, for my Mom the agitation, anxiety, crying started about 3:00 pm. We tried Seroquel but found that it had no change on her behavior. We switched her to Risperdal which helped better to calm her behaviors. We did need to give Xanax as needed for breakthrough anxiety.

We gave her Risperdal each day before behaviors would start. We learned to watch for certain signs that anxiety was beginning to escalate and then gave the Xanax. It wasn't every night. I guess the best advice I have to give medications before behaviors are full blown. If we waited too long my Mom was so agitated she would not take the medication.

We also learned to help control her environment -TV too loud, certain programs, getting dark early in winter- these things would escalate her agitation. Music was soothing to her.

It is a hard thing to live through for both your Mom and you. I will keep you both in my prayers.

Hope this helps

FloydSnax

Live In

I guess I don't ask the right questions when I see her doctor or I'm not getting my point across. I totally need something for when this behavior starts up or even better, when its at full bloom at 1 or 2 in the morning. Cuz I know at a facility they would...I don't even wanna think what they would do to my mom. I'm gonna look deeper into this. Thank you very much for your response. This sucks.  

sunnydove

Hi Floyd.

My mom was never that bad, but definitely affected by Sundowning. I got bright white curtains to pull over the windows when it starts to get dark. We always keep all the rooms lit as any dark room in her vision is distressing to her. And I have twinkle lights year round over the doorway in the room we spend the most time in. Also could help to put on something fun and upbeat on the tv. We like America's Funniest Video Animal Edition and I try to get excited about it and point out all the silly animals to keep her mood up. This is for sure a hard time of year with the days so short. Good luck. 

Malka

My dad was delusional and aggressive and I asked the Dr. for an anti-psychotic. She prescribed Seroquel. He takes 12.5 mg at bedtime. He can take it in the morning also, but the half pill at bedtime works great. The first day it was like he was a zombie, but by the next week it had evened out. He hasn't had delusions or been aggressive at all. His mood is even all the time. Also, the doctor told me that the dosage can be increased as he becomes used to the drug.

There are other anti-psychotics that will work.

Ci2Ci

When my LO, earlier on, did show some sundowning (wandering around at night), I started her on 10mg of melatonin* at ~dusk. She didn't continue to have that behavior, so I've assumed the melatonin had a positive affect. I also instituted a "lights out" time, to which she complied. ...That said, my LO has always had poor sleep hygiene; and with dementia, she would sleep ~20 hours per day at home -- awake to toilet and eat. (Easily stayed awake when we were out & about.) So, hard to say whether the melatonin really helped her circadian rhythms, given her round-the-clock sleep.  But, melatonin is natural and considered benign, so a good first try.

Seems that my LOs most recent behaviorial issues aren't considered sundowning, but:

Her neurologist prescribed Olanzapine/Zyprexa 2.5mg fast-acting, dissolving tablets "prn" -- the medical term for as-needed.  (They only prescribed a total of 5 though!) It is referred to as an "atypical antipsychotic", suppose to be a more 'gentle' med. Perhaps a fast-acting, as-needed would be something to ask your doctor about?

(My LO has been in geri-psych for the past weeks to be established on scheduled, maintenance antipsychotic. She is now on AM & PM doses of Olanzapine; PM low dose of Mirtazapine; and her usual daily AM esCitalopram. [Not happy about all that med! Hope a doctor will work to determine the minimum needed.])