Medications

cdiscipio

Hello, I am new here, but I’m a caregiver for my mother who is in the moderate to late stages of Alzheimer’s. My dad is her primary caregiver. I am seeking any advice on what medications may have worked for others. She sundowns everyday around 3 or 4 pm wanting to go “home” trying to walk out. She gets angry and behavioral. Seroquel does not seem to be working. She is already on Zoloft. She is followed by a neurologist, but I was just wondering what other caregivers have found effective in calming their loved one with similar behaviors as far as medications. Thank you. Any advice is appreciated.

M1

Hi and welcome. What dose of Seroquel is she on? Could be you need a higher dose than she's getting....

harshedbuzz

Is she taking Seroquel daily? Once or twice? Or is he giving it "as needed"?

HB

DCCEPEK

Respidol is helping us at the moment but doesn't stop the wandering. Mil is 84

pookabera

My dad is on seroquel, we give him 2 pills a day (AM & PM) and it's helped so far. It took a couple weeks to fully integrate into his system. Thinking we'll need to up the dosage soon based on his levels of agitation and waking throughout the night. I think he's in the later stages of the progression.

If you're not already, I would recommend keeping notes on her behavior (time ranges for sundowning, sleeping, napping, if she's eating, etc.) My dad's hospice nurse is unable to spend much time observing him (because he's easily agitated and very resistant to anything "medical"), so the nurse asks us to compile notes on all those sorts of things so he can get a full picture.

Marta

Yes, the Seroquel dose likely needs to be increased. But it’s a fine balance between too much or too little. This is why PWD with behaviors are often admitted to geriatric psych units to make these adjustments in a safe setting. That recommendation may not come up until there is a crisis, though.

So call the provider who prescribed Seroquel initially. Name would be on the med bottle.

Marta, NP and AFH administrator.

cdiscipio

https://alzconnected.org/discussion/comment/197374#Comment_197374

Hi and thank you for replying. She is on 25mg in the morning and 50 mg in afternoon.

cdiscipio

https://alzconnected.org/discussion/comment/197433#Comment_197433

Thank you!

cdiscipio

https://alzconnected.org/discussion/comment/197414#Comment_197414

Twice daily, 35 mg in morning and 50 mg in afternoon.

M1

Check with her dlc, but you've got plenty of room to increase. One way qdo it would be to increase the morning dose to 50, keep the afternoon dose at 50, and add a third 25-50 mg at bedtime. Doses of 400 mg per day are used in dementia but up to800 mg per day are used in schizophrenia

ButterflyWings

@cdiscipio what M1 said. My DH has been on 3 doses a day for years now, with Dr. titrating the amount up by 25 mgs when we needed to figure out the right overall amount for best effect. We quickly increased from 75mgs daily to 150 and eventually to 300. That still works perfectly for DH. Not sedated and previous urgent attempts to leave the house especially by early to mid afternoon subsided to his just getting up and walking around and around the kitchen table, or opening the fridge and cabinets repeatedly or just "messing" with whatever he sees on the counters or bookshelves.

Timing for us is 1st dose in the morning, 2nd dose about 1 hour before sundowning, and last dose right before bedtime. So, we've kept the doses about 6 hours apart (except during the middle of the night while sleeping, or trying to.)

H1235

Usually there would be a follow up appointment after a prescription to see how things are going. Maybe the doctor intentionally prescribed a lower dose with the intent to increase it gradually as needed.