Confused about Seroquel!

avieDa921)

My DH (6 years ALZ) has been on Seroquel for almost a week for some agitation, delusions, hallucinations. Sometimes after I give him the 25mg pill, he gets agitated. It might take 30 to a hour for him to chill out. He is on 25mg twice a day. His first is 12:30pm because usually he is good in the mornings & sleeps sometimes late. The next pill is between 8:00-8:30pm. Evenings are the worst times for agitations, delusions, hallucinations (sundowining). I read where it can take up to a couple of weeks to get acclimated. The doctor said I could give it to him 3 times a day if I needed to. He’s always good in the mornings, so don’t want to give the pill. DH not recognizing me might start late morning early afternoon & it comes & goes. I’ve gotten used to it, just don’t like the agitation, kind of scary! Am I not being patient on how this medicine is suppose to work?

M1

You can titrate up the dose fairly quickly. You could try 1.5 pills (37.5 mg) twice a day as your next step up without hurting anything. There is a wide dose range, typically up to 300 mg/day in dementia but up to 800 mg/day in schizophrenia.

Joe C.

When I started DW on seroquil it took about 2 weeks to see any improvement and about 6 weeks to see the full benefit of the medication with some tweaking of the dosage along the way. I remember calling her neurologist after the first week to say I did not see any improvement but she convinced me to give it more time. In the end the seroquil was a huge help in managing her delusions. My wife reaction when she first started taking it was it made her very sleepy, almost comatose, but as she acclimated to the medication that effect subsided.

harshedbuzz

@avieDa921)

Is the medication being prescribed twice daily with the option to add as needed or is it being prescribed as needed?

We found it more effective to medicate proactively so that dad had a steady level of the medication on board rather than reactively. My mom wanted to wait until he "needed" medication with the result that he had to suffer the upset driving the behavior until the meds kicked in assuming he'd take them cooperatively. At the end of the day he was taking the same of medication in a 24-hour period, but it wasn't working as well to keep him mostly settled. I noticed that by keeping the level of medication consistent, he didn't need to be titrated up after we added the second dose because he didn't as agitated.

YMMV.

HB

subversivevegan

We also tend to keep a steady dose for my LO (Vascular Dementia). Note that there are quick AND timed release versions so you might want to try a different choice, in addition to possible dosage changes? I find it easier to keep my LO more comfortable using a combination of quick and timed release tabs.

harshedbuzz

@subversivevegan

(Awesome screen name, btw) Excellent point. Our pharmacist approved crushing the regular Seroquel but not the extended-release version.

HB

subversivevegan

Good point HB about not crushing extended release version! Thanks for the reminder.

avieDa921)

https://alzconnected.org/discussion/comment/193912#Comment_193912

I’m giving it to him before he has any symptoms because it might take too long to take effect, especially when he gets angry with me & wanted me to leave last night because it wasn’t me. I guess I’m not understanding why does he get agitated more easily since he’s been on the medication for a week now. Doctor said he could have 25mg 3 times a day. I’m going with 11/2 twice a day since he’s always good in the mornings & sometimes sleeps late.