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I have a friend from church, who is caring for his wife and she is seeing people and gets very fearful ,as it gets later in the afternoon.

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Seroquel works great for my mom as well. Though it is sometimes trial and error to find something that will help. Mom started taking it three years ago with 12.5mg that gradually increased over time and she has just started taking 100mg daily at 4:00 to help with sundowning behaviors.
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I agree with Dopaday1. My husband was having delusions and agitation late in the day. The delusions left and the agitation got much better after the Doc put him on Seroquel.
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Some doctors are now ordering an old drug called Seroquel. It has been very helpful for those who are hallucinating or become uncontrollable late in the day.
One particular family caregiver says it has really helped his wife become easier to manage. You may ask about it.
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Namenda and Alprozalam have been very helpful to my mom. She still has sundowners at times. Gets arguemenative, cranky, unreasonable. I try to leave the retirement home before 6:00. And unless she calls I dont have to deal with her. Today I got the usual "this is a PRISON", and I want to get out of here.
There is NO WAY she could live without someone dedicated to her needs
Of course, she can't see how much is done for her. (I agree the food sucks, but I take her alternatives which she rarely remembers or will eat even if I'm there to heat them up and serve to her.). She forces herself to eat something, but 10 min. Later can't tell you (or incorrectly tells you) what she got for supper. It's an unending battle. I'm lucky to be able to leave and go home when the Sundowners are coming on.
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Shortstop, Maybe the dosage needed to be increased. My mother started with 10 mg and was increased to 20 mg. The geriatric psychiatrist helped her a lot. Wish the best for you.
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Awesome aprildp just stopped moms a mmonth ago was giving it n morning may need to try afternoon evenings sundowners, paranoia, and delusions r so bad. Thx again
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Hi Shortstop,
I have my mother take Prozac around the same time every day - usually between 4:00 pm - 5:00 pm. I believe it could be taken any time during the day as long as it is around the same time each day. I selected this time because it works best for my mother. It is before she has dinner.
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Apirilpd when does she take her Prozac?
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My mother's doctor referred her to a geriatric psychiatrist when she was experiencing sundowner syndrome. At that time she was on an anti-anxiety medication, which the geriatric doctor took her off becasue he said it wasn't helping her.

He then prescribed an anti-depressant. It took some time to get the right anti-depressant which worked for my mother. She first took sertraline (Zoloft) which she stopped because it caused stomach problems and diarhea. She then was presecribed escitalopram (Lexapro) , but came donw with hives. The third anti-depressant she was prescribed was fluoxetine (Prozac), which she has been on for some time and has had no side effects. She is doing well and the anti-depressant has helped her sundown symptons greatly.

It does take some time to find the right medication which works. And it takes a lot of patience too!!!
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I was so surprised after 7 months when I little corner was deco in lobby as fireplace 2 chairs and a table when we went by it she said " oh my God it's I living room! I had not realized how much she missed it. I am having a very hard time with guilt now.
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The anti and Meds changed my mom to someone else. What I discovered was not seeing sun up and down and the true light of day increased it. I believe in no Meds and common sense of going outside a lot. Had I not been retired and there daily this wouldn't happen enough to go outside. Off Meds and out daily esp seeing rise and set seemed to help. God bless. Oh also familiar things. Fear increases it. It is a protection reaction when new area is not home the mind goes home. Any talk of not believing what they r seeing in their minds eye confuses, scares and makes worse. Bringing fave things from home seemed to help. Also seeing a living area other than halls and bedroom settings.
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Everyone is different. What works for one wont work for the next person. A year ago mom was prescribed lexapro because of het anxiety. Within a few weeks she became hallucinatory, delusional, paranoid and angry. I asked the dr if maybe it was the lexapro. Oh no, they said. The dose was too small and nevet ever heard of anyone becoming psychotic from a mild dose of an anti anxiety pill. So then they prescibed exelon which didnt do crap so they took her off that :o). Then serequel was prescribed which got rid of some of the anger and different hallucinations. Then aricept was introduced. Still seeing things and imagining things that weren't there. Then one day mom decided on her own to stop all 3 of the drugs. I was bracing myself for the worst. Within a few weeks the hallucinations stopped. Realized it was the lexapro starting the probs from the gey go. The drs act like none of this is related. Is mom cured? Of course not. She still has dementia but the hallucinations and angry paranoia is not there. So you never kn ow how one person will react to a drug. One person's cure is another person's bad reaction.
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P S Dementia is not worse because of stopping Namenda XR but seems to be better for her every day living. She is having problems with stomach and back pain which are also side effects of Namenda. We have had her to FP Doctore, Spine Specialist and GI Specialist and they cannot determine what is causing her pain. I am very upset since they give her narcotics ans send her home instead of finding the source of the pain and the narcotics also caused her issues. Does anyone have suggestions as she has been to hospital for testing and other Drs and still no solid diagnosis and treatment.
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They changed my mother in law to Namenda XR because insurance would not cover the Namenda twice a day. Hallucinations started after the first day. They got worse as the days went on. We stopped the Namenda XR and the sundowners has not reappeared. She is more interactive. We just brought her out of assisted living to our home so I am not sure if the regular Namenda caused the same problems since we were not around 24-7. She is less disoriented now. The dementia is getting worse but we no longer are up and down all night.
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My husband, age 84, was having sundowning. The Doc discontinued his Aricept, Ativan and Wellbutrin and added Namenda, Seroquel and Zoloft. He takes Namenda, Zoloft and 1 Seroquel (25mg) in AM and 1 Seroquel around 5:00pm. This really helps the sundowning. He also takes 100mg at night to sleep. I think it is like others are saying; everyone is different so what works for one may not work for another.
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Diazepam may help.
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My Dad is on Depakot, along with Namenda, & Aracept. The Depakot is for bi-polar and seems to even out his moods. He still gets some anxiety late in the day, but otherwise, he doesn't get overly angry anymore. I am so thankful for that!
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Sometimes mood stabilizers are helpful. Sundowning often culminates in violent behaviors in the afternoon or evening. Depakote is an anti seizure medication that is frequently used for mood stabilization with few side effects. Risperdol is another good one as mentioned above. I have also seen Seroquel used if there is are symptoms of psychosis. I have seen Xanax used for intense anxiety for distressing delusions which has a longer time of therapeutic effect than Ativan. You will have more success with this type of problem from a Psychiatrist with Geriatric experience than from your Primary Care Physician.
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I got my mom a supplement called:
Phosphatidylserene. It's a brain supplement that helps with clarity. My mom was way over medicated. The drugs bring on sundowners. The more drug you give the more they have a hard time until they are comatose.
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My mother gets sundowners and they gave her risperdol and some other meds, but everything seemed to agitate her so we took her off those meds as the doctor said at her age they were not good for her any way, we now use Sunny Day, its a natural and it seems to calm her
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I have to say, my husband came home from a hospital stay w/scrips for Namenda and Seroquel. He had classic sundowners until we dc'd the seroquel. He did well on Namenda and Arosept.
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I remember when I was younger, people saying, when you have AD, you won;t know it, you will be in another world and it will be peaceful. That was a pile of BS. I think most AD patients are very agitated, and scared and worried. My husband developed a bleeding ulcer! Not worried? Not much!
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take her to a doctor and advise them of the situations that have taken place. they should be able to prescribe something and like someone said, it might take a couple of tries to find the right dosage. and the easiest way to get them to take it (if they fuss about taking pills), put the pill in some pudding and just give them a taste of it (spoonful) along with some water then. thats what they do in the NH that my father is in. they give it at the same time every day in a small cup of pudding. he actually mentioned to the nurse the other day that they forgot to give it to him (even though they didn't). wishing you luck.
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Sundowners suck. No other way to say it. Mom takes attivan, seriquil and amitriptyline and there r notes we r up all nite .looking for a baby someone stoked or listening to voices. I think there goes a point w meds dosages needs to b increased..Good luck keep ur head up
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My mother-in-law developed Sundowners from her sleeping pills. The doctor prescribed another medication and the problem was solved. Your friend is lucky to have you for a buddy!
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Hi Carol! I was having some problems with my mom's sundowner's that seemed to be getting worse, especially after 6:30 P.M. but sometimes as early as 3:30. She started the "I want to go home" and occasionally would try to leave. Then when the caregiver started coming later she became more and more agitated and combative even, so the caregiver suggested that I call the doctor and see if they could prescribe a medication to calm her down as the symptoms were becoming more and more unmanageable and every night was like a battle zone! The doctor prescribed Lorazepam which is the same thing as Ativan. She has taken it for the past 2 nights. Since then she has been much more pleasant to be around and we have had no issues with her becoming scared, agitated, combative, or wanting to leave. Best of luck to you and I hope this helps!
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My mom takes namenda and it works well. Plus other stuff I am not sure what. Also, ativan for anxiety, she has a lot of that. When she had audio hallucinations she was taking clonopin and risperdol. both worked fairly well but didn't calm her down enough for long.
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My sister wasn't sun downing, but she had delusions that everyone (neighbors, the dentist, me, etc) was stealing from her. She obsessed about the imagined stealing day and night, and was always scowling and accusing A tiny dose of risperidol has removed her paranoia, and she is much much happier and more relaxed. She smiles and is pleasant all the time now. No apparent side effects. I wish I had known about this when my mother went through a paranoid period.
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my dad was on aricept and a low dose of ativan, also another alzheimer's med. it seemed to work, unfortunately, he passed jan 13, 2015 after 11 years of alzheimers
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Check out the website Sundowners Facts on the Internet. You may find the information there helpful...hope so!!
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