Medication question

Drapper

My DH’s neurologist suggested that he begin taking low dose Seroquel. This is in addition to Klonopin , which he has been on for a couple of months to better control behaviors and anxiety. She said that he would need to stop using Aricept (donepezil 10 mg) as it should not be taken with Seroquel.

I wanted to see has any of you were given this same advise. If yes, was there an impact of eliminating Aricept. Did you stop it cold turkey, or lower dosage. Thank you.

Marta

Seroquel and other antipsychotics can reduce the efficacy of donepezil and other acetylcholine esterase inhibitors, but imo this is not a reason to stop taking the donepezil and I do not advise my patients to do so.

You might call the neuro’s office to clarify, as you may have misunderstood the instructions.

Rocky2

DW is on seroquel and donepezil.

M1

I too have never heard that they could not or should not be taken together. Given that the donepezil has very low efficacy anyway, I doubt that there will be any consequences to stopping it.

FTR Seroquel has a chance of being very effective at controlling or damping down his behaviors and is likely safer in the long run than ongoing use of Klonopin (a benzodiazepine). It is commonly used and generally very well tolerated, though not by everyone--there are occasional cases with atypical reactions, so be watchful especially at first. Hope it helps.

Drapper

Thank you all for your comments. I’m very confused about the whole medication situation. I’m not sure what is the best approach yet

My DH was seeing a psychiatrist for the purpose of medication to control behaviors and anxiety that was on the rise. Neurologist was not helpful in this area. So we tried lexapro , which had opposite effect. Wanted to do klonopin , which I was afraid of , so then went to seroquel. Which definitely made him dazed and tired at low dosage. I then switched neurologist , who was opposed to seroquel until we tried other meds. (Stopped seeing psychiatrist, as this neurologist would do prescribing )

so we started over. first Zoloft , made him more anxious. Augmented Zoloft with Short acting Benzodiazepines, which made issues bigger as they wore off Then low dose Klonopin which does help a lot, very long lasting but still has outburst for no apparent reason and still prone to anxiety. I know meds take a while to get right.

I wanted to put him in an adult daycare but his behaviors were still an issue there. So neurologist suggested we go to seroquel again. (But would have to stop Aricept ? ? )

in the meantime , I joined careblazers , and am trying out dr Natali recommendations. I’m trying to see if we can do without seroquel, for awhile anyway, but not sure yet, Still on Klonopin .5 2x a day.

sorry this is so long. It’s a slippery slope. My DH is also going to start with a geriatric dr over next two weeks. Curious to hear his viewpoint. Also my DH is continuing to decline. So situation is fluid He is mid stage (Stage 5 maybe ) doesn’t think he has any issues so dr apppointments are stressful for him

So I am working on my behaviors (part of of careblazers philosophy ) it is the only thing I can control in this strange land we are all in

M1

There are other atypical psychotics besides Seroquel that could be tried--or it may be a dosing issue. Risperidone/Risperdal is the other common one, but there are others, too. Hope the new geriatrician will be of some help.

SDianeL

At the VA, rhe Neurologist just started my DH on Risperidone low dose at night. They then referred him to a Geri Psychiatrist who will monitor him and manage his meds. We have an appointment next Friday. Too many cooks in the stew in my opinion. Glad one doctor will monitor his meds.