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My 89 year old father was recently diagnosed with late moderate stage Alzheimer's. His hallucinations and delusions are increasing. The neurologist who diagnosed him prescribed Seroquel .25. He tried it once and refused to take it again because he could barely stand a half hour later as he was going to bed. I could not convince him to try a half of the pill the next day or at any other time.

I had a consult with his primary care doctor. I am going to try and crush a half of the pill and put it in his food at the doctors advice. If this doesn't work, I am going to try Risperdal in liquid form to put on his food. My father flat out refuses to take any pills. His doctor is aware of this. Has anyone experienced crushing Seroquel and putting it in food? The pharmacist said it is not the time released form. Or adding the Risperdal liquid to food of a non compliant parent? He can be quite suspicious.

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how do you crush the pills with what and what are you mixing them in? I have been caring for Mom the past 8 years and this past month have had nothing but issues with her taking her pills - she is on 7 daily - I work and have to work to pay the bills - I don't know how much more I can handle with this pill situation every day - any ideas? thanks Jane
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Mom has PD and dementia. Without Seroquel at night, we would both be locked up! It was suggested as something to calm her down during the day, but she also could not function with it in her system during the daytime. It works well for her at night and she wakes up refreshed. Years ago when she was still "with it" she was prescribed risperdal and it made her CRAZY!!!! Her doctor them gave her Remeron for at night and it helped for a long time. He said it was like having a glass of wine before bed. But as her dementia progressed, she needed something more. At this stage of her disease, I feel comfortable with most drugs her doctor prescribes. That would be her neurologist as she is most familiar with what she is experiencing. Her primary care defers to the neurologist in most cases.
Like any drug, everyone reacts differently to them and no one knows how until the medication is tried. Unfortunately it takes a combination of many different meds to help PD patients with dementia and it takes time to find the right combo. Then Their condition will change and so the meds will need changing too.
Flyaway, you can definitely crush seroquel. Extended release pills however, should never be crushed. Try applesauce or pudding. That has worked for mom for years now. However, yogurt is the one thing you don't want to give meds with. It coats the stomach and keeps the body from absorbing the full dose.
Good luck with your dad!
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It is all so scary. We all love the ones we care for and we all want to feel like we have made the best decisions. We are just now going to start my daughter , 16, with special needs on an SSRI drug and I am terrified! Even though I have been on them for over 10 years. We want to believe our doctors , we research the meds ourselves and try to come up with the best choice and we pray that we cause no harm. It is so so scary. But when our loved ones have reached a phase where their general health and well being are suffering we have to do something. And we get scared. I know that many of the people with my daughter's syndrome are on Resideral(sp?) and her psychiatrist mentioned it as a possible route for her in the future. She mentioned the warnings and I honestly cannot see myself, now, going that route and I wonder how some of the parents can risk it but I do not walk in their shoes. It is never an easy decision to make - to put a person on psych. meds and it is a very personal one. I do hope that everyone feels free to tell their story- especially about the anti-psychotics- and I hope that the stress we feel for our loved ones and our decisions doesn't bleed into the forum. We are all just trying our best.
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There is an excellent article on an NIH website summarizing the potential risks and benefits of using anti-psychotics for other than the conditions they were originally developed for. It also has a list of things to think about when you are trying to decide whether to use such drugs. It is non-technical. You can read it here:

http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1192

It covers several specific drugs, including Seroquel and Risperdal.

I mention my "la-dee-doda" doctor simply to illustrate that many, many doctors who study the issue carefully and have full medical histories on their patients do feel the potential benefits in some cases outweigh the potential risks. In treating dementia, there is no one-size-fits-all prescription.

By the way, within about 8 minutes of taking Seroquel my husband couldn't stand, either. That is why I gave it to him only after he was completely ready of bed and in the bedroom. That effect wore off in a couple of hours, and if he had to get up during the night he walked fine. If he had needed the drug in the daytime I'm sure we would have tried a much smaller dose, but as it was it worked great for its intended purpose.
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Jeanne Gibbs never gives "immature" responses and her answers are always spot on. My husband (young onset AD, 9 years duration, Stage 7) has benefited greatly from Seroquel and Haldol. Even if there are black box warnings, he is calmer and easier to manage than w/o those medications. Quality of life is important, and the hospice nurse said the patients are not enjoying their agitation, etc. Thank you Jeanne Gibbs for all your answers!
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Flyaways father couldnt stand after taking it, that calls for a different medication route. Everyone can do what they want and listen to who they want but depakote is just like any other drug that can hurt your liver, like lipitor, but in his opinion safer. It has far less warnings than seraquel and thats the point I was making. The caregivers here, as far as I know, love any and all suggestions possible. I was hoping to help someone and do not need to be critized. Myself, I appreciate all ideas, thoughts and suggestions that anyone gives me here and then I do my own research. To tell us all that your neurologist is so la de doda better than my Moms Dr is a bit immature. We are supposed to be here to help one another, not put down, and thats all I was doing.
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Reverseroles, I like to look drugs up on the National Institute of Health's website. The Depakote spirnkles (valproic acid) entry starts out with a big warning box that includes "...may cause serious or life threatening damage to the liver..." and "may cause serious or life-threatening damage to the pancreas." Maybe that is not too important for somebody who is near the end of their life. I certainly know of other caregivers who really appreciate this drug. But no drug aimed at the brain is to be taken lightly and most drugs have potential drawbacks.

My point is just that prescribing appropriate drugs is more than just knowing about warnings. It is weighing pros and cons, and the trade-offs for the particular patient with his or her particular history. No doubt there is some mindless prescribing going on out there, and it is good for us to do some research.

My husband's doctor is the head of the neurology department at the Mayo Clinic in Minnesota. He is a very well-respected clinician and and a world renown researcher. He is considered one of the foremost experts on the type of dementia my husband had. And he prescribed Seroquel, which was very effective in improving quality of life for my husband for nearly a decade.

Suggesting that someone drop a doctor just because they've prescribed Seroquel is a bit extreme.
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flyaway, I would get a new doctor and see about safer drugs. My Mom is on depakote sprinkles, a life saver! She was beating up my caretaker , taking off up the street, and needed her brain calmed. We had the head of neurology who doesnt recommend black box drugs. I know it works for some but just a thought , hope this helps.
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I was fulltime caregiver for my MIL with AD for the last two years of her life. She passed away last month at age 93. Although she did not take a lot of medication, I was having to crush up her pills for the last several months of her life; she just couldn't seem to handle them otherwise. I was told that they would still be effective crushed. She was on Seroquel for the last few months, but Risperdal had been prescibed first. I gave her the Risperdal only once. It was one of the worst nights of those last two years. After that, the doctor switched to the Seroquel and that worked much better for her hallucinations and some other behaviors, but there is nothing that really seemed to make a huge difference. Mostly just keeping things very calm, quiet and routine seemed to be the key.
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Risperdal should not be taken lightly. It is a black box drug antipsychotic drug that carries a warning from the FDA that it is not approved for use in patients with dementia because it can cause severe side effects, and even death. Your doctor seems rather cavalier about giving this deadly drug to your father, as most doctors are. My father was given Risperdal in a hospital then in a nursing home without our knowledge or consent. When we asked why he seemed to lose his mind, we were told it was "sudden onset Alzheimer's." He suddenly became a diabetic, and suffered from dehydration, heart troubles, and sudden decline in kidney function, all because of Risperdal. He was dead less than two months after being put on Risperdal. We didn't know he was on this drug until I obtained his medical records. Unless you father has been deemed unable to make his own decisions, he should have the right to refuse any medications; he probably doesn't like the way Seroquel makes him feel (this being another antipsychotic drugs). I can understand what you feel as a caretaker because I was my father's caretaker for 3 years. I wish there was an easy answer.
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My husband took Seroquel for 9+ years. I figured he had an 8-minute window between when he took it and when he needed to be in bed, so I took to giving it to him only after he had his pajamas on and was sitting next to the bed! However you give it to your father, be very careful of the timing!

Toward the end, I crushed all of my husband's pills, including Seroquel, because of swallowing difficulties. When he was on hospice we dropped the Seroquel along with most pills, but we soon added the Seroquel back in. It did make a difference in his level of agitation.

The Seroquel should work crushed and mixed into food. The issue I see is does he eat some food right before he goes to bed? Having the pill with dinner is not likely to work.
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