Severe Agitation - Seeking guidance on what works

Daughter of a Marine · January 19

Just reaching out to this community which has become a tremendous blessing and lifeline as I navigate the unknown territory of dementia as caregiver to my HWD. He is 76 and was diagnosed 11 yrs ago. Progression was slow until he had back surgery 2 yrs ago and was under anesthesia for 5 hrs. He has never been the same since. Now I'm seeing a level of agitation and confusion I'm finding it very difficult to manage. This week has been dangerously cold and he has insisted on being outside, either wiping off the car or in the yard continuing to gather leaves and debris along with snow - wearing no hat or gloves in 4 degree temps. I can always anticipate an argument over showering, brushing his teeth, wearing clean clothes, not driving, etc. I'm hoping for some medication recommendations - he takes Seroquel at bedtime but lately i've seen ads for Rexulti. Can anyone recommend a med or another approach? Thank you in advance for any guidance you can offer.

M1 · January 19

Id call his docs about increasing the seroquel dose. Rexulti is similar and a lot more expensive. In a pinch, try adding a Seroquel dose earlier in the day (can be dosed three times a day even). I'd start with giving him 12.5 or 25 mg in the morning and work up from there. May make him sleepy to start with but that's better than freezing....

avieDa921) · January 19

My DH is on Seroquel, going on 3 weeks now. He started with 1 25mg before bedtime & that didn’t help him as far as during the day. I give him 1 25mg at 12:30 pm & 1 25mg at 8:30pm. He no longer has agitation like he had & not as many delusions! It’s nice to have less stress & to be able to get things done again!

Daughter of a Marine · January 20

Thank you both - this gives me hope! I forgot to mention that he does take 50 mg of Seroquel at night and it does help with sleep and reducing those nighttime hallucinations. I called his neurologist yesterday and he said to add another 25 mg of Seroquel during the day when he's agitated. I picked him up from adult day care this evening and he again insisted on shoveling (he was shoveling snow off of our grass, not the sidewalk). It was 12 degrees and he would not come inside. No one knows how difficult this road is unless they've walked it.

avieDa921) · January 20

Here’s what I found out, you don’t wait till he’s agitated. Keep giving the pills everyday at the same time. His system has to get used to the medication for it to work properly!