Drugs

jecoiner

what drug works best to manage delusions?

M1

welcome to the forum. There a number of choices, but the best tolerated are the atypical antipsychotics like Seroquel/quetiapine and Risperdal/risperidone. Rexulti is a newer one in that family that has a specific indication for agitation in Alzheimers disease, but it’s very expensive and not clearly better than the older, cheaper drugs. All of these carry an “black box” warning about risk for heart attacks and strokes in older adults, but the risk is actually pretty low, and the delusions are usually so unpleasant that most decide the trade off is worth it.
Other ones used in more refractory cases are Zyprexa/okanzapine and Depakote/valproic acid. Someone recently had good results with an anticonvulsant called Lamictal/lamotrigine too.

ButterflyWings

Seroquel/Quetiapine has worked wonders for us. I’ve said many times, it was like a magic pill. Literally has made it possible for me to care for DH at home all this time, making a super stressful mid stages manageable.

Currentjy Stage 7 and 300mg a day keeps him mellow, non-sedated, and more easily redirected though dementia still throws us the inevitable curve balls.

The occasional delusion is not a crisis now, and using validation techniques, fiblets and on the job experience + Seroquel is the reason. Meds disappeared his worst delusions and hallucinations.

Rick4407

Seroquel was a wonder drug for my DW her last 3-4 years. Worked up slowly from 25mg to a max of 75mg per day spaced out, early afternoon (50mg) and then evening (25mg). Her last 5-6 months reduced to just 50 mg and then none her last couple of weeks. I gave them to her in instant pudding or applesauce.

mommafour

Just adding to what others said - Seroquel is working wonders for my DH. He has been taking it for over 1 year. He is currently on 200 mg per day and doing okay (at least as far as very minimal/mild delusions or hallucinations).

wizmo

Those drugs mentioned also not specific to delusions but work on various psychotic behaviors to help stabilize mood. I accepted mood swings were part if the disease for quite a while until it became disruptive, then started asking neurologist for options. Seroquel was the first choice for us too.

jsps139_

Seroquel is working so well for my DH. Hallucinations are all but gone and the delusions are occasional minus the anxiety and agitation. It makes life so bearable. My DH is now taking 50mg after dinner and his Dr just prescribed 25 mg in the morning. He naps quite a bit but at least he is calm when awake. His sense of humor is also back - I’ve missed that! I hope it is as helpful for you and your LO, if you decide to go with it.