seroquel usage for 93 year old with dementia for the past 11 years.

scarfire · April 14

i'm at the end of my rope as far as care-giving goes. my mother was diagnosed in 2014 with AD/dementia. she advanced quickly and has been in late stages for the past 9 years (requires complete care 24/7). her delusions and bad behavior have become difficult to manage. she's started throwing dishes and glasses of food/drink lately.

we've been giving her 25 mg of seroquel at night to help her sleep for the past 3 years. i want to increase the dose. the dr recommended 25 mg in the morning and 25 mg at night but this has not helped.

i've read that up to 100 mg per day is OK for dementia patients.

what doses are people on the board using? obviously we would run it by the doctor before increasing.

her behavior is abusive, delusional and i don't like to see her suffer such mental anguish.

thanks!

vtech1951 · April 16

Did you just say your mother has been in late stages for 9 years!!!!! Ours has been this way for over 3 and a half years and its been total hell!! So this potentially could last another 6 years or more?? Please give me strength!

harshedbuzz · April 16

My dad mostly leveled out at 25mg 2x a day, but I have heard of other families needing 100mg 3x daily.

IME, geriatric psychiatrists are more comfortable and creative at prescribing this class of medications than either PCPs or neurologists. Dad always showtimed and was utterly charming during his appointments, so I email video clips I made of dad acting out. Before that I got a sense the psych thought I was trying to drug him into a stupor. A video might be worth 1000 words. Just sayin'

HB

SusanB-dil · April 17

How long has the dosage been increased? It can take a week or two to see any change. Also what HB said... geri-psych and video...

SDianeL · April 17

you can have her transported to the hospital Geri Psyche unit so they can manage her meds before they release her. No need for her to be agitated. Has hospice evaluated her?

Marchbanks · April 17

Like others have said, she needs to be evaluated by a geriatric psychiatrist for medication management. Mine sees a geriatric nurse practitioner. She has been a godsend. 50 mg is a low dose. I recently upped DH dose to 75 mg. You could easily double or triple that but make an appointment with a geriatric psychiatrist and include a video if you can. The nurse told me she sees patients that are on 300-400 mg day. Obviously you wouldn’t want to start with that.

midge333 · April 17

There is one study that shows 100 mg of seroquel per day was no better than placebo and 200 mg per day is quite effective. I think seroquel is often underdosed because of all the FDA warnings…

https://pubmed.ncbi.nlm.nih.gov/17316169/

scarfire · April 18

https://alzconnected.org/discussion/comment/241041#Comment_241041

thank you for all your replies. i think the geriatric psych is my next move. she sees a neurologist but is always pleasant and never shows any signs of her bad behavior in her office.

and yes, vtech1951, she has been late stage for 9 years. she needs complete care from getting out of bed in the morning to getting back to bed in the evening. it's been a grueling 9 years for me and my family. the bad days have become more frequent so i'm hoping that we can adjust her seroquel and calm her down going forward.

vtech1951 · 5:19AM

https://alzconnected.org/discussion/comment/241151#Comment_241151

Im going to play devils advocate here,,some mourn when death comes, other mourn when death doesnt come as everybody suffers year in and year out as we have been going through 3 years of hell with no end in sight, not to mention the money drain every month from expensive caretakers.

harshedbuzz · 10:48AM

https://alzconnected.org/discussion/comment/241129#Comment_241129

That's a very interesting paper. It in no way reflects my personal experience with the medication at all. Through no fault of our own, we took part in a double-blind study.

My dad was initially started on Seroquel when he was given a working diagnosis of Alzheimer's and referred to a doctor at the memory center. He'd been agitated to the point of aggression before the hospitalization, and I feared for my mom once he was released from rehab and realized we'd moved them near me. They'd been spending the year split between FL and MD and needed to move to PA after mom almost died in dad's care. The doc started him on 25mg at dinnertime to help with sundowning and sleep. It didn't extinguish the behavior entirely, but it dialed it way back to manageable. He adjusted to rehab and was there for 7 weeks.

Because he didn't have a local physician yet, the SNF's doctor sent his current prescriptions to the local pharmacy giving us time to establish care with a new PCP. Within a week, dad became angry and aggressive in the evenings— threatening my mom and keeping her up all night with angry threats. After the third call in as many nights to come calm things down, I double-checked with mom that he'd been taking his meds. She said he was, so I went into the cabinet to check and discovered— much to my horror— that the national chain pharmacy had given dad refills from some random dude with the same name and DOB. There was a lot of overlap on the meds— same BP and SSRI meds and slightly different doses of metformin and statin but no Seroquel. Without it, a mere 25mg, he was a mess.

FTR, dad's geripsych suspected that he came to dementia with bi-polar disorder based on his personal and family history. Atypical antipsychotics, like Seroquel, are the go-to meds for this condition albeit at higher doses typically than those used for dementia; those with schizophrenia might also be prescribed these meds at even higher doses. On the other hand, I know of children with ASD who did well on a halved 25mg of the same.

HB

seroquel usage for 93 year old with dementia for the past 11 years.

Comments

Commonly Used Abbreviations

Community Guidelines

Categories