Antihistamine to calm down

Malka

Hi,

My FIL has some form of dementia, I don't know what his diagnosis was and neither my husband or his siblings seem to know. FIL is 92 and gets very physically aggressive and verbally abusive with his aides (and his family). He was started on Serequel 100 mg at night and 25 mg in the morning. Family didn't like that he was so tired first thing in the morning. So they stopped that dose. The family doesn't understand that patients usually need the dosage to be increased as the patient acclimates to that dosage.

My FIL hit his aide the other day. My husband wants to add the morning dosage back in. His siblings don't, really only one sibling cares. She want to give him Robitussin to make him tired so he will sleep. Does anyone on the forum do this?

I think this is a very bad idea. Opinions welcomed.

Thanks,

M

Marta

Who has the medical POA for your FIL? That is the person who should be making decisions about meds in consultation with FIL’s medical team, not anyone else.

Robitussin is a cough suppressant, not a sedative. It can have unpleasant side effects like hallucinations. It’s a bad idea to use it in a person with dementia.

The POA should be discussing the situation with FIL’s medical provider, who has already made appropriate recommendations for Seroquel. Family should not be adding or discontinuing medication without the provider’s knowledge.

storycrafter

Seraquel's side effect of sleepiness disappeared after two weeks of use for my husband.

M1

You are correct Malka, it is a very bad idea. Antihistamines can cause increased confusion, falls,and urinary retention.

Medicine by committee is also a bad idea. Who has medical poa? Everyone else should hold their tongue.

harshedbuzz

@Malka

Medication changes of any kind should be discussed with the prescribing physician. Full stop.

They sound more medically ignorant, as a group, than most. This isn't meant to be an insult or a reflection of their intelligence, my own college-educated mother has a lot of "interesting" beliefs around medicine and well-being. I wonder if their communication style is impacting how your FIL was medicated in the first place. Who wrote the initial prescription? Was it a geriatric psychiatrist or neurologist or PCP? Typically, so dementia patients, Seroquel is started at a lower dose-- often 25 mg once or twice daily-- and increased if the PWD needs a higher dose to control agitation and behaviors. My own dad did OK at 25mg twice daily, but doses of 100mg aren't unusual. In your shoes, I would ask to reduce the Seroquel to 25mg at night and increase if needed.

Seroquel is sometimes given for sleeplessness. If the family was reporting someone who was not sleeping at all with aggression trending towards violence, the doctor may have felt compelled to start at a higher dose for safety. Seroquel can aid sleep. In the first week or so, it might make a person groggier but this typically passes.

Oy, on the Robitussin. In it's classic formulation, it's just cough syrup. The nighttime formula does have an added antihistamine- Doxylamine Succinate- which is an anticholinergic medication associated with decreased cognitive function in older people. There may be a relationship between long term use and dementia. It should not be given to the elderly outside of an acute allergy situation.

HB