Looking for Feedback on Quetiapine

BikingOldMan

At my DW's last visit with her neurologist it was suggested that she begin low dose quetiapine twice a day. (split 25 mg tablet). OK. So I never start her on a new medication before I have had an opportunity to evaluate the potential risks/rewards of using the medication. Reading the manufacturers medication guide #1 of their "…most important information" to know about quetiapine potential side effects includes .."1. Risk of death in the elderly with dementia…" I know that quetiapine is being used with dementia patients, apparently with mixed results. I'd like feedback from those caregivers whose LO has been or is using quetiapine, and for what reason they are using it. I haven't started her on it yet.

Salliek

my DhH was prescribed, by his careful GP, that exact prescription. I am aware of its help with his evening restlessness , followed by a good night’s sleep.

​fesk

Can you let us know why that exact medicine was prescribed?

Antipsychotics carry many risks but sometimes they are needed. However, in my opinion, some doctors prescribe them before trying what could be considered safer options.

BikingOldMan

https://alzconnected.org/discussion/comment/268022#Comment_268022

Direct answer, no, I can't tell you why. We didn't discuss any alternatives, I wasn't familiar with quetiapine. Our discussion leading up to it was around the significant behavioral changes in my DW since the last appointment. I hope to create the opportunity for further discussion with DW's primary care Dr and neurologist.

persevere

Quetiapine is otherwise known as Seroquel. If you search this site you will find a plethora of posts about it. It is the first and mildest of the antipsychotic drugs usually prescribed to help with agitation/delusions, etc. Behavioral issues. I think it is prescribed to help with sleep also. I would not be afraid of it if I were you. My wife is up to 300mg a day at this point. What he has prescribed is a very very low dose. I don't think you get out of 'low' until your up around 200 or 250 - don't quote me on that. You are right to be cautious with any drugs. But at some point you will probably find that you have to get over that hump. If you see side effects let the doctor know.

Bailey's Mom

My HWD has tried Lorazepam and resperidone,which both made him worse. His delusions and paranoia are off the charts now, and we are getting no sleep, so his PCP is prescribing Quetiapine…starting next week. I don't think things can be worse than they are now, so am willing to give it a go.

​fesk

You mention behavioral changes. If that is agitation or aggression, it could be why an antipsychotic was prescribed. All medications affect people differently. Seroquel has been very effective for some while making others worse. There is no way to tell how it affect your wife.

When I encountered a similar situation and an antipsychotic was offered, I asked for other alternatives which were successful for many years. There did come a time when we did need an antipsychotic, but that was years later.

Only you know the specifics of your situation. I recommend having a frank discussion with the doctor and asking all the questions you need to. Then you can make a decision you are comfortable with.

harshedbuzz

@BikingOldMan

Behavior is communication. Often, anxiety drives behaviors that can't be articulated by PWD.

12.5mg/twice daily is a "baby dose" of Seroquel. Generally, the lower doses used for agitation/behaviors in dementia are much lower (<300mg/day) than those used for bipolar disorder and schizophrenia.

While it's true that Seroquel, like other medications of this type, carries a Black Box Warning many, many caregivers have found the benefits outweighed the risks. For dad, Seroquel gave him an extra year at home with my mom before moving to a lovely MCF. Without it, he would have ended up in a facility that accepts more challenging residents which may have limited our ability to visit often.

HB

Belle60

My DH started experiencing behavioral changes in the evening. Outbursts, crying, paranoia, etc. I talked to his neurologist and she prescribed 25 mg once daily in the late afternoon. It took a while but those behaviors have gotten better. Not completely gone but greatly diminished. It took a while to really make a difference. But it did make life easier. I don't like medication either but at some point you have to recognize life can be better through chemistry.

Abby627

My DH has been on Seroquel for over a year and it has helped immensely. He takes 25 mg each evening. He has stopped his nighttime agitation and sleeps very well all through the night. He doesn’t get up until after 9 in the morning. I would not hesitate for a minute to use the med. It was a life changer for us!

Appletree4

my DH is own Citalopram which seems to calm his aggressive tendencies- he gets really upset .

yardman49

My DW was initially prescribed 25 MG Quetiapine by her neurologist but had little effect of reducing agitation and restlessness. He increased to 50MG which I crush the pill and mix into her dinner food each evening. It has worked great most of the time when she consumes enough of her food. We are able to get a good night's sleep most nights. Yes, the medication has warnings, but our primary geriatric care doctor said he has had no issues with any of his patients for years.

Bailey's Mom

My HWD took his first dose of quetiapine last night (25mg)…he fell asleep at the dinner table and then could bareley talk, couldn't walk without assistance, couldn't find the bedroom, said he didn't want to live anymore, fell into bed and has been asleep for 12 hrs now. Since it's the weekend, I will not be able to talk to his PCP, so am thinking about calling the pharmacist to see if this is a normal reaction for the first time and if I should split his dosage in half or discontinue it altogether. He also takes donepezil, sertraline and lovastatin. Anyone else experience this kind of reaction?

Rick4407

Seroquel was the miracle drug for my DW. Started a low dose 12,5mg and stepped up slowly. Used for over 3 years until stage 8. Usually 25 mg after lunch and then 25 mg in the evening. In tough times up to 50 mg for a couple of weeks then back to 25mg. Always crushed and mixed into a snack, apple sauce, pudding, etc. Less agitated, slept well and just "happier".

tonyac2

I ditto what @harshedbuzz said about benefit risk factor. The dr explained all of that and I decided to have him try it. Our experience is almost exactly like @Abby627 DH sleeps through the night and well into the AM. It’s been a game changer for us. He takes 50mg @ bedtime.