Seroquel drug for dementia person's angry behavior in an assisted living facility?

Seroquel had definite cognitive decline effects on my mother. It was given to help
with sleep but within three weeks she could not follow directions nor answer in
complete sentences..As HCS , I directed that they take her off after reading the studies about the cognitive decline in the elderly on the seroquel. I would not ever
use this one again. Wiithin several days, she was speaking to us in sentences and following simple directions, walking better. She needs to keep the good brain cells that she has and not destroy them. The family and caretakers know them better than the doctors do. Best Wishes with your loved ones

I have been a in-home caregiver for 30 years..I have seen pretty much everything.There is out here..I was taking care of my patient..And best Friend...Who also had this dreaded disease.The VA was taking care of him at home along with Hospice ..He was given 6 months to live..Like they really know!!His family insisted that they stop all Phychotic Meds.At first they said this is what the Dr.ordered..His wife said I am his POA and I said NO!!!!!Needless to say the med's stopped..They put him on((( Reminyl ))That is for Alzhimers & Dementia...And 1mg, Ativan at night..The G-tube was removed in 4 months.He started Pt again.And was coming to the kitchen on with his walker..Oh he also started going to church again.I would push him around in his wheelchair and all the neighbors would just be in shock!All this happened with in 8 months.His VA Doctor and Hospice was shocked..I started with him on 6-21-09-..He loved me and I loved him and his entire family.We lost the fight on 9-12-12 due to complications of A gallbladder surgery ..Not to this awful disease..I think my point here is..Speak up you know your love ones better than anyone else..The old saying if it walks like a duck and talks like a duck..It's A Duck!!The nursing homes and hospitals do care..They are just under staffed.And loaded with paper work..It's the Doctor that need to be held accountable.And believe me..You have the right to say..Hey doc I don't think so..We are going to try it this way..Or I will be getting another Doctor..That simple..Really it is, I've seen it happen..And you must find A caregiver that cares.If dad is always sitting and you know he can walk..Tell who ever is caring for him..I want dad busy .If hes sitting he can sit in A wheelchair and be pushed to the mall or dinner..Or just to the hill to watch the Ducks swim..And count the new ones each year..I miss you Mr.Dillon and will see you on the other side.I hope this has helped..As I sit here with my Mother-in-law.That I took out of the nursing home with Alzheimers and Dementia..That was so dehydrated that she had scabs on her tongue..And was in the fetal position..She is sitting up having A little coffee..And oatmeal..And at night is driving me crazy with the sun downers..Until I give her her Ativan 0.25mg..And refused to give the Seroquel that they increased to 200mg at bed time..Because she was stiff as A board..And fighting me hitting, spitting, cursing....And was out of control..I will not give it to her..And as long as I say NO they can't make me...I wish you all the best and will Pray for A great outcome..

Finally got my husband back on his depakote. Seems to help along with the seroquel.

If my mom with dementia/AD wasn't on Seroquel (lowest dose 2xday), she'd still be kicking the staff, spitting out most meds, and throwing her food! She had a terrible reaction to Ativan, and anti-depressants do exactly the opposite. She's never had a UTI, and they plan on cutting back the Seroquel IF she continues to be more mellow. Depakote has been mentioned, and I hope it will level her moods out a bit more...although she may save the worst "grouchies" for our visits! ;-)

One of the leading researchers on Dementia with Lewy Bodies is Bradley Boeve,
Chair, Behavioral Neurology, Mayo Clinic. One of his widely used publications includes a four-page table of symptoms and the drugs that are suitable for them, in this disease. Quetiapine (Seroquel) appears on the list twice, for two different symptoms. In neither case is it listed first (as first choice) but it is one of many tools for fighting the symptoms of this dreadful disease.

So while in general Seroquel may not be a good choice for older persons with dementia and while it is apparently not very effective in Alzhiemer patients, that does not mean it should never be used in particular situations with a known diagnosis that responds to it. It has been effective for my husband (Dementia with Lewy Bodies) for 9 years.

To prescribe Seroquel (or any anti-spychotic) for symptoms caused by a UTI is ludicrous.

WE have had very similar experiences . Mom's situation all started with a raging UTI.Even being Mom's Health Care Surrogate,
a neurologist who had talked to me in her hospital room went out and prescribed
four different mental health drugs- all new :geodon, ativan, depakote, and namenda (a listed allergy for Mom) at the same time taking her off of her celexa(2 yers on ) and
aricept(4 years on) cold turkey and NEVER TOLD ME A WORD as I sat in Mom's
room not 12 feet from the nursing station. I was trusting that I would be told what I
should know. Do not ever assume that. I have learned my lesson. I was asking
questions from day one, but learned to daily (or at least everyother day) get a PRINTED med. list and go over it with a pharmacist. They know a lot more about the interactions and side effects.The Seroquel was the last of 12 mental health meds
that Mom was given in 18 days, and Mom was a chemistry experiment gone bad.
Her situation got to the point the cardiologist came in due to high heart rate and
had to assess the heart. Gave a med for lowering heart rate to counter what
were the side effects of some of the behavioral meds. We almost lost her one day
because the heart rate lowering med worked too good, and she got close to
flat lining. Mom doesn't have a heart problem, she was having a med problem.
Anyway, the best thing I started doing was consulting with two of my family
members who are pharmacists. If you have a local pharm. that you know, they
will give you information that can assist you . Every new med needs to be reviewed
by a good pharm Dr. or experienced pharm. The hospital pharmacy was not even
catching Mom's med. allergy list and gave her two medicines listed on the list!. What a nightmare. I can identify with your situation. We have changed hospitals for future visits.
Seroquel was helpful for a short time to get agitation symptoms quieted , so Mom
could sleep. We are now on the third antibiotic for the same UTI ,now back on
the original Aricept , Xanax,and Celexa and stopped the Seroquel after consulting pharma-cist , reading research and med. notes on Side effects. It has taken my
research and knowledge of Mom working with her gen. doctor to get her back.
Oh, and the neurologist, I had to fire him the next week. Too many drugs and no
communication.

Risperadol is an anti-psychotic that has been used successfully for dementia. It is an older, first-line med; Seroquel is not. Everything I have read on Seroquel states that it is NOT for dementia and it is NOT for elderly patients. It was the point I was making above about being so upset at the Psych doctor for putting my 95 y/o mother on it without my knowledge. The Dr was treating her UTI symptom behavior with it, as though it was a psychosis -behavior that the antibiotic would clear by itself! It was outrageous! The Seroquel side effects of hallucinations, derlum, and more were continuing in mom well after the antibiotic should have cleared up her behavior. It was why I finally pinned them down to find out what else they had her on. Rude awakening -antibiotic yes, but also Seroquel, Effexor and several others. It's no wonder she was a walking zombie and still delirious. I'm still angry about that experience with that Psych doctor in that Behavioral Unit.

I used to just kind of hate antipsychotics too because so many people have such bad effects, but have been forced to acknowledge that for some people they are absolutely necessary anyways. Gratned, that's rare overall, compared to the number of people who GET them, and sometimes for non-compelling reasons, but its sure not zero. If there are no structural brain abnormalities, the likelihood of durg-induced parkinsonism is much lower, but you can still have dystonias and insulin resistance, etc. Here in Arkansas, Medicaid is now requiring regular fasting blood sugars or HgbA1cs and lipids for even the kids getting minidose for autism and sensory defensiveness issues, which may be overkill, but I suppose gives people more respect for their side effect potential. One of my most favorite patients ever absoutely has to have some just so daily life is anywhere near manageable, so all I can do is add enough Cogentin (benztropine) to counteract the motor issues...Jo165 is absolutely right, you have to just watch like a hawk and see what works for any individual. I once had a patient look like they were getting an MS relapse on Celexa, but for most people its fine if they need it for anxiety or depression. Sometimes staying on very low doses if key, but a lot of the psych folks have been taught to do the opposite.

I just had my mother taken off of Serquel after her speech and cognition had
declined suddenly while being on this med for only a couple of weeks.
Read the 2005 study which addresses the elderly with demetia on this medicine.
It is filed with the National Institutes of Health and addresses cognition decline and
aggitation. The generic name is used in the literature and is Quentiapine.
Mom had been put on this for sleep aide and aggitation at night . Within 3-4 days
of coming off of Seroquel
we saw a definite improvement in responses, talking in sentences again, and overall
understanding/ following directions. She is taking Celexa-antidepressant for the demetia(diagnosed for 5 years)/ Altz. along with low dose of Xanaz for anxiety.
Mom has also been on a low dose (she doesn't tolerate much of meds.) of
Aricept 5 mg for the last 4+ years.
We have to watch all the symptoms very closely. You know your parents better
than anyone, so listen to your head and heart and READ, and READ about these
medicines.

I don't think all antipsychotics are all bad for everyone, but side effects are a huge issue. And Seroquel does not work for treating UTIs (or MIs, or any other causes of delirium)! Addressing the behavior and not its cause is a mindless error and I think it still happens way too often. I once had to insist on my mom going to a regular medical ER instead of a behavior uint - and that's where they found she'd had a second MI.

Glad to see this topic. Good advice to run, not walk, from Seroquel. Mom (95) was put in the Behavior (psych) Unit of her hospital after a 7 day stay in the regular section hospital when her behavior had gotten totally out of control. On the 8th day there was finally a diagnosis of what we had already been sure was another UTI (finally pseudomonas was identified in her culture).

Her behavior had become bizarre in the hospital -hallucinations, paranoia, aggressiveness- but we had discussed with the BU personnel that it was absolutely not her usual behavior and we were certain it was a UTI -which as I said, by the next day finally, was determined. Another day lapsed before they finally starting her on an antibiotic to get rid of the UTI. After several days in the Behavior Unit after the anitibiotic was started she was still acting so very odd when we expected substantial improvement. So I finally asked if she was being given other meds in addition to the antibiotic. She was still hallucinating, angry and very zombie like.

I was frankly shocked to find the psych Dr in the behaviorial unit had ordered Haldol (more than once) injections and had started her immediately on several anitspychotics including Seroquel! I had expected them to give her some sedatives, but was furious to find what they had been doing. I was even more angry that we were not informed about meds that are not even recommended for the elderly. Seroquel specifically warns that it should not be used for the elderly. Its for schizophrenia and other serious mental disorders. I requested the Dr wean her off the psych meds immediately which she grudgingly finally did and then they basically kicked mom out of the Behavior Unit. When I asked to be advised of what they were prescribing the psych Dr refused -said she couldn't work that way. I am persona non grata now to the Behavior Unit -fine with me.

Mom did recover from that UTI and did stop the really troubling side effects of the psych meds (hallucinations, etc.), but did not fully recover mentally from her trauma in the Behavior Unit in June of this year (2012). She has had 5 UTI's so far this year (end of April to September) and has rapidly declined into horrible dementia since that June episode. I blame the UTI's, but also think the psych meds were a major contributing factor. Be careful and insist on knowing what the Dr's are prescribing. Then look them up yourself to make sure what they are.

Frankly I would like Mom's GP to try her on Xanax or Ativan (longer working form of Xanax) for her anxiety. Both her younger sister and older brother (in another State) are on low doses for their anxiety and it seems to be helping them with no ill effects, but mom's GP is trying other things first.... God, dementia is the PITS!!!!!

I agree with everyone saying NOT to take the antipsychotics. I am not mentally ill but I was forced to be on these antipsychotics for months while they injected them into me.

They cause permanent and irreversible brain damage. Other drugs can be bad as well, but the antipsychotics are on another level. They can't do any good, they can only sedate people for a while. If you care about your parents at all please do not even consider getting her to take these things. Due to the trusting nature of the internet along with aggressive marketing of these drugs it's highly possible there are shills strongly advocating their use in forums like this.

Seroquel has worked well for my husband with dementia. Helped with his behavior so I can continue to care for him. Granted he still has issues but not as dangerous.

To Sunshine 73- My mom with Alz has been on Seroquel for 5 months. She was hospitalized with severe agitation for 12 days last spring. They tried several meds including Haldol which made her coma-like. Others made her manic and seeing things. She's been on a low dose of Seroquel. At first, for about 3 weeks while she adjusted she forgot how to eat (needed to be fed) and developed OCD behaviors, but she adjusted and now she's more herself than I've seen her in a year. She's content, friendly and emotionally appropriate. The Doc wants to wean her off it, but I'm leery, because she's so much better off on the drug. The risks seem like a small thing compared to her daily happiness and contentment. She's in a nursing home.

Our doctor put my mother on Seroquel months ago as a 'sleeping tablet' when I reported that my mother had been getting out of bed in the night and stamping around shouting her head off at her hallucinations.
A few months ago I took her down to see the doc because of her behaviour (she's always been very aggressive towards me - she has NPD), so the doc upped her dosage to two Seroquel a day. It has helped somewhat, she's not getting out of bed and shouting for hours, and she spents a fair few hours of the day asleep on the couch!

Seroquel caused my 91 y/o mother in assisted living/memory care to hallucinate (people were in the air conditioner looking at her) and have extreme agitation (kicking and arms swinging) for several hours after it was given to her for anxiety. It took a sitter and myself to hold her so she would not harm herself. It may work with other persons, but not my mom.

From the product literature - SEROQUEL XR can increase the risk of death in elderly people who have memory loss (dementia). SEROQUEL XR is not approved for treating psychosis in the elderly with dementia.

Dada has been on seroquel since January. We are fortunate that it seems to have controlled his psychotic episodes . He receives a small dose 25 mg in the am and 50mg in the pm. For now this seems to be working and although I also read about the adverse effects on the Internet and grilled my dad's geriatrician we both decided to try this drug. I feel the benefits have been great and now 8 months later dad is having anger issues. I can not say if it is a side effect of the drug or his frustration over losing control over day to day activities. I will speak to his doctor about depakote. My dad is 97 years old. I am thankful that I gave this drug a chance and it has been working for this long. Dad still walks with a walker and his appetite is good. So I feel this drug was a good choice.

What about the use of other anti anxiety medications such as Abilify?

The first time they gave my mother seroquel in the hospital she was seeing little people taking food off her dinner plate. I have repeatedly told hospital doctors and nurses to quit giving my mother seroquel and they just keep doing it. I have told them that I have read reports that say seroquel should not be given to elderly people with dementia. They look at me like I'm from another planet and just keep doing it.

What about the use of other anti anxiety medications such as Abilify?

I also was cautious of the different drugs used to calm my mother after episodes of anger and agitated behavior. She was not on a large dose of Seroquel, but when she was exploding with anger and paranoia a few weeks ago, the psychiatrist upped the dose and now she is focused and calm. I can have a conversation with her, although her confusion may still be quite evident. She remembered our topic of discussion from one day to the next which was not happening recently. So I am not displeased with how she is reacting. Perhaps it is individually specific.Obviously, if she has any side effects, like those previously stated, I will tell them to withdraw the drug.

Some people have had good results with Depakote sprinkles, ask her dr. :-)

Hi - my mother has vascular dementia and Alzheimer's. She was put on Resperdol for her angry outbursts but this did nothing much for her. The specialist we see has now put her on Seroquel and we had a terrible reaction with it at first. Apparently she was not on a high enough dose. the dosage was doubled and she has settled a little more but still has outbursts. I don't think any drug will have a great effect for my poor mother. The specialist has said that she has BPSD - Behavioral and Psychological Symptoms of Dementia. This is a phase of the disease that not all dementia patients get. However, unless it can be kept under control by any of the psychotic drugs available which all seem to have horrendous side effects, she will end up in a lock down ward sedated all of the time. There is no easy way to treat anyone with these symptoms and my heart breaks every time I see mum. My dad is alive at 91 years old and is with her in the nursing home. he gets the brunt of her mood swings and aggression and I hurt for him. Unfortunately there is only one way this disease/ condition can go and it is not good.

Lamictal is another mood stabilizer (used first as anticonvulsant like Depakote). My mother takes it for bipolar disorder. I don't know whether it would work the same way as Depakote, but it doesn't have any liver effects, as Depakote can. Lithium is another drug that many doctors are afraid of, but can be used sometimes with close monitoring, and I think it's been shown to have a calming effect. My mother also takes a low dose of that. See an article from the journal Nature in 2003 called "The Ups and Down of Lithium." I think lithium has been unnecessarily ostracized. I far prefer it to any of the antipsychotics. I guess this better serve as a disclaimer that I favor it, also for myself. It's true that it can be dangerous, but that is why it must be very closely monitored. You always have to consider the alternatives, which are not all that attractive. Lithium also seems to have a protective effect on neurons.

Depakote!! You can get it in sprinkles and put in pudding or on food. My Moms neurologist is the head Neuro at the hospital and he always uses Depakote. He doesnt believe in seraquel type medications as they cause heart attacks , strokes, and can make them crazy hyper. Please ask for it, its only a seizure medication that calms the brain, its so safe , really, compared to anything else. (no my mom never had seizures)Lorizapam will cause constipation and make him unsteady on his feet, he will not be agressive on depakote, let me know if you have any questions. Good Luck!

My dad has been in a nursing home 4 months, they reduced the SSRI he was on (per NYS law) and the aggressive behavior began. He does have Aleheimer's, is very strong and gets around unassisted. He has hit staff, other residents. He has been given Seroquel in increased increments (now 3 x day 75mg.) and now Lorizapam morning, noon, and every 4 hours "as needed" Now when he talks he makes no sense, is out of it, and has absolutely no recognition of me. What is a better drug to use to control his sudden aggressive outbursts so everyone is safe.

I agree 100% about the antipsychotics. I think the jury is still way out on what good they do and why. And many dangers are clear.

I looked using Mendeley for articles on d-mannose. Here's one very specific to UTIs that I found: "Structural basis of tropism of Escherichia coli to the bladder during urinary tract infection." You can find that one by title. To paraphrase what I *think* it means, d-mannose seems to take up spaces in the bladder wall structure that e. coli would bind to. And prevents the binding of the vast majority of e. coli bacteria. I'm planning to back up my argument to the doctor using this and a couple of other articles. Have to be sure to understand them first! But it can be done.

Mannose is in fact good stuff for UTI prevention. Actually ANY infection can set them off. Seroquel and all the related drugs can cause dypshagia. If and only if you and the docs find your loved one absolutely cannot do without an antipsychotic once everything else is identified and treated, one way to decrease the side effects, besides minimizing rather than escalating doses routinely, is to add a medication called Cogentin (benztropine).

Sometimes, I could not get other docs to keep mom on the supplements that helped her either. Maybe pulling a PubMed abstract or article to back you up would be worth a try.

Wow, I almost forgot, here are some things that work for us. Mom fell and broke her arm, after that, two UTIs both needing a hospital stay, then colitis, all from the pain medication (lortab, Vicodin). We used d-mannose, which seemed to work well before. But after she got home from the last (fourth) hospital stay, she already had another UTI (!). She had not had d-mannose during those stays. I don't recommend this for others, but my research showed that d-mannose was believed to be pretty innocuous, so in desperation I doubled the amount she takes. I watch her urine now every day and she's had no problems for about a month. That's my hot tip. I also heard Mirelax was harsh, though we had to resort to a massive dose once. Milk of Magnesia comes in tablets, if your mom can't stomach it like mine. I also do a prune routine with Metamucil.

When my mother took Seroquel, muscular weakness was a big problem. And it persisted for quite a while. Is there any way the doctor could get back to you sooner than Monday, or anyone else who could help? I think you're doing the right thing by cutting the medicine back. Anyway, that's what I would do. Because it seems that she got worse after the new dosage. And the fact that she's having trouble swallowing pills, sounds like the muscular weakness my mother had.