Suggestions on "sedatives" please

I am in the same place as Laurie 1282. My DH is in Stage 6, except psych doc started him on Rexulti. He has a closet ful of samples because I could not afford this drug. He is not a Geri psych but a good doc and we are limited in options in our area. My DH didn't respond well to 1mg. Increased it to 2mg. The aggitation, hallucinations, lack of sleep got worse. The bottom fell out last Wed. He was so agitated, could not sit still. Kept talking about his delusions. I can't understand him anymore but give him my undivided attention. I'm able to pick up an occasional word so I know it's all hallucinations and delusions. He has gone through every part of the house drawers, cabinets and leaves them on the floor or relocates them. I emailed doc asking for help. He responded that we could try Trazadone for sleep and he would add on Seroquel,if I wanted. So ball is in my court but this happened so fast and I didn't know anything about these drugs. So I went online reading this forum, watching alk the YouTube videos that seemed relative. The only conclusion I came up with putting him back on Namenda. Found Geri psych dr. who has treated dimensia exclusively for 20 years. He advised not taking them off donepazil or Namenda. He said unless there are bad side effects which my husband didn't have, it's best to keep them on it. He said especially don't go Cold Turkey which is what happened with my husband. He said he had a patient who's wife stopped him cold turkey, and he had an immediate deterioration where he couldn't feed himself anymore. He got the man back on the Namenda and he regained almost everything he lost. I emailed Dr last Thurs and have heard nothing. I thought of going to ER but felt, I would waste at least 12hrs if not more and they would just start playing with meds maybe put him on fluids and send him home. We didn't get any vaccines this year always do but kept putting it off. So when I hear Grass done and Seroquel, I am scared. Definitely out of my league! Sorry this got so long but I needed to vent. I am all alone, no family, no money to get help, no daycares. Only thing is a nursing home but I didn't want to warehouse him but I am 72 have some health issues and have to keep everything together.

My DW takes a muscle relaxer (Flexerall) before bed and she sleeps like a baby. She’s not yet at the hallucinations stage yet so not sure what I will do then.

My DH takes Trazodone for sleep and it helps a lot. He's taken this for several years.

We had to increase his Sertraline to 100mg recently due to agitation. He now also has a prescription for Ativan to use as needed when his agitation goes sky-high. This was all necessary after an episode of extreme agitation and repetitive behaviors that might have harmed him. It took two doctors (his geri-psych and PCP) one month to get the prescriptions written. Our health "care" system is a joke. But now at least I have something in the cabinet when the next episode hits.

My DH was having delusions, hallucinations, and angry outbursts at me, as well as waking up during the night. Dr started with 25mg of Seroquel at bedtime. It worked for a few months and then he needed a dosage change to 50mg at bedtime because the anxiety and agitation came back. Dr adjusted again to 50mg in the am and 50 mg at bedtime. That was the sweet spot - he sleeps all night, the delusions and hallucinations are very rare now, and although the angry outbursts do still happen occasionally, they are more tolerable. Remember not to look for perfection, but look for tolerable - it helps to adjust our expectations with this horrific disease.

Sorry the Seroquel didn’t work for your LO, but I thought this may help someone else who hasn’t tried meds yet.
I hope you find the right meds soon. It makes a huge difference. ❤️

Risperidone am and pm that he has taken for about 3 years. For sundowning which starts around 1:30pm these days and goes to about 7:30pm, 100 mg gabapentin because it makes him a little sleepy. He also takes 300mg gabapentin plus 6mg melatonin before bedtime and usually sleeps through the night. The nighttime gabapentin was for neuropathy and leg cramps, but a side effect was sleepiness. I asked his neurologist if we could use that during the day, 100mg for agitation. We tried trazadone but it didn’t seem to help at all. The 100 gabapentin does help but takes over an hour to start working. He also takes memantine (generic Namenda) in the am and pm, which I think is very helpful for empathy and maybe a little calming?

Everyone is so different and things do change, so I hope suggestions given here might help in your case. I certainly appreciate the question. It’s helpful to know what other things to try.

Edited to add: We tried Seroquel in the beginning that worked for a very short time at a very low dose. Increased dosage twice over a short time without much success. It was probably still too low of a dose. People here seem to have success with increasing the dosage in the beginning. Risperidone worked better for him. Dosage increased once.

Klonozipan has worked well for my DH, along with Seroquel. I’ve been told it is a mild version of Xanax. It helps with agitation and helps him sleep.

I work in a MC and there are some meds that help our residents that we used frequently. For the sleeplessness we have residents that are taking Melatonin. For the increased agitation, we have used Risperidone, Seroquel, Olanzapine, Depakote and Diazepam.