Can Seroquel cause cognitive decline?

Palmetto Peg

My HWD's neurologist prescribed 50 mg of Seroquel at night to help calm down his aggression. He is also on Cimetadine for hyper sexuality. The aggressive behavior has calmed down a bit, but I also feel like he has declined cognitively. Is this what happens? I am much better able to handle him now, but he can't remember simple things like how to charge his watch, which he could do a few weeks ago. Any suggestions? I hate to go back to the fear and sleeplessness of him before Seroquel, but I also hate the idea of perhaps speeding up his decline. He has also become less hyper sexual and has stopped grabbing and groping all the time, so I am thankful for that, too. He has been on both new meds for about 10 days. Thanks in advance!

M1

I wouldn't expect it to cause decline per se Peg, especially in only ten days.

​fesk

I'm going to disagree. Everyone reacts differently. A different antipsychotic caused a very noticeable decline in my mother's cognitive abilities. I could see her abilities continually lessening over weeks/months. I also remember reading this can happen. When we tried to take her off the medication, you could see the difference. Her thinking cleared and she was doing things she had stopped doing. I tried different medications but they did not work for her. So, unfortunately, my mother needs this medicine so I keep her on the lowest dose possible to manage her symptoms. It bothers me to this day that it has this effect.

I am very glad to see you are in a better place though with the behaviors.

tigersmom

Peg, for what it’s worth, I did feel my DH’s cognition got worse on seroquel. I posted about this, too. It also made him incredibly sleepy, even at the low starter dose, and altered his gait. But I definitely felt he was more confused on it. We gave up on it after a month and switched to risperidone. Just increased the dose quite a bit, and it is not doing good things for his walking, either. But it’s clear he needs one of these drugs, so I am staying the course. I wish he did not, but his afternoon anger and exit-seeking are out of control without them. How I envy the caregivers with loved ones who are easy.

Palmetto Peg

I am coming to that same conclusion, tigersmom! Even if it does accelerate the cognitive decline, I can't manage him without it. Even with it, today is a terrible day. He has been nasty and mean all day, and calling me a drunk. He says I drink two to three bottles of wine a day, and he wants me to leave. He poured out what he could find, including a lovely bottle of Chianti I bought for him. I have a glass of wine at night with dinner, but he has turned it into something so much bigger. He tells people that I am a "f'ing drunk and orders me to leave the table at dinner (we all eat in a communal dining room). I am probably going to look into memory care soon. I was hoping that the Seroquel would be enough, and although it helps, it is still so hard. I plan to talk to his neurologist on Monday. What a terrible burden for all of us! I wish I had an easy one, too!

Dio

So sorry you're going through this. It's more than envy whenever I hear a PWD is easy to care for. Memory care may be the answer when behaviors become unmanageable. However, MCF may only take in residents whose medications are squared away. If extreme aggression is not controlled, either they won't accept or they'll evict after moving in if combative behavior causes potential harm to self or others. Hope you find the right medications.

midge333

Peg,

It sounds like your DH needs a morning dose of seroquel in addition to his evening dose. Hopefully your neurologist will get things squared away for your DH. Be safe and don't hesitate to call 911 if he becomes threatening.

ButterflyWings

I can now say that my DH is easy to care for. But that is due to a fairly high daily amount of Seroquel. Morning, afternoon, and night.

Would he be more cognizant without it? Maybe - but his dementia would still progress (decline), and I would never go back to the sheer drama and risky behaviors we faced without the antipsychotic intervention.

It is a trade off I would make every time. No regrets.

midge333

My DW was miserable (delusional, tearful, angry, agitated, etc) before she was started on Seroquel. With dosage increases she is somnolent for a week or two and then adapts to the new dose. If it shortens her time on earth, so be it. Thus far, it has allowed me to keep her at home.

M1

Agree Peg, i would add a morning dose. Do it tomorrow and then call the doc on Monday. Im so sorry, you don't deserve to be humiliated like that.

jsps139_

https://alzconnected.org/discussion/comment/214991#Comment_214991

I agree 100%! I would make that trade off every time also!

​fesk

I made the trade off. I haven't made peace with it. Yes, she's calmer, but I am still angry that it hastened her decline and there is not a better option. I hope for all of us, better options present themselves soon.

ImMaggieMae

https://alzconnected.org/discussion/comment/215018#Comment_215018

Every dementia patient is different and has different rates of progression. So how can you really know what caused her rate of decline? A PWD that is extremely agitated or frightened by hallucinations or delusions is probably even more disturbed by these symptoms than their caregiver is. We do what we can to make things a little better. And nobody really knows if they hasten decline or even how they actually work. We do the best we can without a lot of choices.

tigersmom

Peg, I am so sorry you have to endure terrible insults like that. My DH, formerly the nicest guy on the planet, has hurled some choice ones himself. I would encourage you to start looking at memory care facilities. I have seen four and am visiting two more this week. I never thought I would do it this soon, but his eloping in the middle of the night at the end of May was a big wake-up call. I view keeping him safe as job number one. And every day when 3 pm rolls around I wonder what I am going to be dealing with. Yesterday the only way I could calm him down was to take him for a walk in 90-degree heat. I thought that touring memory care would be horrible, and I have seen one place that was, but others have made me feel that at least I can formulate a plan B. None of this is anything we asked for, we just have to roll with it. Hugs to you.

​fesk

Hi ImMaggieMae,

I'm aware every person is different and reacts to medicine differently. I make that point several times when I post. I also stated there are no good options and I had to make the trade off.

I know it hastened her decline and made her worse cognitively because, when we trialed taking her off it and attempted different medications, it was obvious. Unfortunately, it's the medicine she needs - hence, the trade off.

I am not passing judgment on anyone - only stating how I feel about my situation .Like I said, I hope there are better options for all of us soon.

Palmetto Peg

Thank you everyone! I am going to try adding a dose of Seroquel in the morning to see if it helps, and I will call his neurologist tomorrow. I am so worn out from the dementia behavior (he says everything is wet and takes all of his clothes out of the closet and dries them one by one) plus the mean, nasty, humiliating remarks that I could scream sometimes. I can deal with the memory loss and constant repetition, but my house looks like a garage sale with clothes strewn all over everywhere, and then on top of that, I can see people here pulling away from us because his behavior at dinner is so outrageous. I am going to speak to the doctors here about memory care. I know they won't take him if he is still so aggressive, but perhaps additional Seroquel will help with that. Your advice is so helpful, and the support is life-saving for me!

​fesk

Good luck.

It's very early with the Seroquel so there's a good chance it may help.

Keep us posted.

SDianeL

My husband is in memory care since February. He was on Risperidone but became agitated & aggressive toward staff when he became urinary incontinent. The doctor added Depakote. He was so medicated he slept except for meals. My daughter mentioned it to the nurse who left a note for the doctor who is gradually reducing his meds to find a happy medium. When he would wake for meals he would not communicate much at all. He was wheelchair bound during the day but with the medications he became bedridden due to fall risk. With being bedridden also came full incontinence. I thought at first it was the disease progression but I now think it was the medication. They must gradually reduce the medication so it will be a few weeks before we see if they can find the right balance. They have no choice but to medicate him for the safety of the staff. It's heartbreaking.

​fesk

I am sorry SDianeL. I hope they get the balance right soon.