<p>My 83 yr old father has been recently diagnosed with dementia (beginning stages) The biggest change has been the degree of his anger. He explodes over almost anything. (It is verbal, not physical). We went to a neurologist that prescribed Seroquel to try. Low dose. After reading the warning I am truly hesitant to have him start it. Has anyone had experience with this?</p>
<p>I have experienced the same trepidation as my 87 y.o. mother was prescribed low dose seroquel. I keep a close “watch” (I live far away) on her physical symptoms and make sure all her docs knows she’s on the medication. Nevertheless she takes one pill at bedtime. It helps her sleep more soundly and seems to have turned down the intensity of affect. It’s been about one month, and so far I am content with the results. Of course I worry all the time…</p>
<p>Has your father ever tried an antidepressant? The SSRIs have a much longer history to assure their relative safety, and some of them (like Lexapro) work pretty quickly: within a few days, not after a couple of weeks like Prozac and Zoloft.</p>
<p>My dad and stepmother (90 and 92) take Lexapro and it really seems to help.</p>
<p>oldmom- he has tried one of the SSRIs in the past and it didn’t make much difference. After about a month he refused to take anything else.</p>
<p>jasmom- Can I ask what dosage your mom is on?</p>
<p>My 96 yr. old aunt was put on Seroquel and Lexapro in March for agression. She has a history of vascular dementia. It seems to be working well with no apparent side effects. She can still be obstinate and cranky, (as the MD said, you can decrease the symptoms but it will not change her basline personality). She usually has some reactions to many medications. We discontinued the Ativan, it snowed her, increased her fall risk and did not decrease her anxiety or delusions.</p>
<p>Stressed2x, my mother takes 25mg.</p>
<p>Stressed2c … my mom just got put on seroquel too. They weaned her off her other anxiety drug (probably ativan) and started low dose of seroquel. 25mg … That was terrible because the transition was really rough. She was very high maintenance for a week while it went on, actually 2 weeks, but I was with her one of the weeks.</p>
<p>They then increased the dose to 50mg and it really seems to have helped. She sleeps better which I think was part of the problem (not sleeping at all makes anyone crazy). She also has the vascular dementia most likely since they see some brain changes in the CT scans they had done in the past (where I didn’t think they could see Alzheimers). </p>
<p>I was scared about it, too. Especially the risk for heart problems as she has a stent already. But I decided to risk it because she was so upset that THAT would give her a heart attack too. </p>
<p>One thing to accept is that these drugs really are trial and error because different drugs react differently in people and goodness knows might react with different meds that are handed out. My mom doesn’t take many really, but it is still al balancing act.</p>
<p>Just remember that seeming improvement by one person is anecdotal and subject to various bias effects. </p>
<p>[USDOJ:</a> Pharmaceutical Giant AstraZeneca to Pay $520 Million for Off-label Drug Marketing](<a href=“http://www.justice.gov/opa/pr/2010/April/10-civ-487.html]USDOJ:”>http://www.justice.gov/opa/pr/2010/April/10-civ-487.html)</p>
<p>"The United States alleges that AstraZeneca illegally marketed Seroquel for uses never approved by the FDA. Specifically, between January 2001 through December 2006, AstraZeneca promoted Seroquel to psychiatrists and other physicians for certain uses that were not approved by the FDA as safe and effective (including aggression, Alzheimers disease, anger management, anxiety, attention deficit hyperactivity disorder, bipolar maintenance, dementia, depression, mood disorder, post-traumatic stress disorder, and sleeplessness). These unapproved uses were not medically accepted indications for which the United States and the state Medicaid programs provided coverage for Seroquel.</p>
<p>“According to the settlement agreement, AstraZeneca targeted its illegal marketing of the anti-psychotic Seroquel towards doctors who do not typically treat schizophrenia or bipolar disorder, such as physicians who treat the elderly, primary care physicians, pediatric and adolescent physicians, and in long-term care facilities and prisons.”</p>
<p>Its use also increases mortality risks. </p>
<p>[Off-Label</a> Use Of Risky Antipsychotic Drugs Raises Concerns - Kaiser Health News](<a href=“http://www.kaiserhealthnews.org/stories/2012/march/13/off-label-use-of-risky-antipsychotic-drugs.aspx]Off-Label”>Off-Label Use Of Risky Antipsychotic Drugs Raises Concerns | KFF Health News)</p>
<p>At the risk of sounding cruel and uncaring (really I am <em>not</em>) …
How to say this delicately… </p>
<p>my mom would be very happy with more calm and a mortality outcome sooner. This I am crystal clear on which helps my decisions.</p>
<p>esobay, I agree 100 percent with this. But I think that especially with dementia patients who can’t necessarily speak for themselves effectively, there’s a risk that although the patient behaves in a more tranquil fashion, s/he may be very unhappy. This was a big issue when my dad started taking Lexapro. When he could still fill his own pill boxes, he would stop taking it, and I could tell right away. And when I talked to him about it, he would say that everyone else thought he was depressed but he was just fine.</p>
<p>OP, a big advantage of Lexapro is that it’s relatively quick–like within a week for sure–to tell if it’s working. I have concerns about Seroquel because of the TV commercials. What kind of marketing technique is that for a complicated drug with serious side effects of many kinds?</p>
<p>I’m on your page, eso. For my late-80s parents, I’ve decided that quality of life trumps quantity.</p>
<p>A snippet from a very recent article on Medscape</p>
<p>“Most behavioral complications of dementia are intermittent and don’t persist for longer than 3 months. Dr. Declercq recommends attempting withdrawal at 6 weeks, or 12 weeks at the latest.”</p>
<p>There was also one called “6 Steps to Nondrug Management of Dementia” , both aimed at physicians.</p>
<p>Doesn’t Seroquel give you that “drugged out” look? Maybe a low dose doesn’t?</p>
<p>mom2 … for MY mom, the seroquel did not drug her out, in fact she was a lot less fuzzy than the month before. The week of transition, she wasn’t drugged out looking, she was crazy angry with beady eyes (and I mean crazy looking angry, too). In the mornings now she is a little more foggy, it takes til breakfast or the first cup of coffee for her to do better, but over-all, she is less foggy.
It has only been 2 weeks since the dose was upped however.</p>
<p>None of the atypical anti-psychotics (seroquel, geodon, etc) are recommended in the elderly. They do increase the risk of the death for them. Yet, the physicians continue to prescribe them in this age category.</p>
<p>I have two recent experiences. Co-worker’s elderly father (dementia) was put on risperdal for some aggressive behavior at his assisted living facility. Went from walking around to dead in 2 weeks. This drug is NOT recommended for elderly folks with dementia. He aspirated (one of the risks), got pneumonia and never recovered. The hospital told my co-worker the drug should not have been prescribed. Did it kill him? Who knows.</p>
<p>My sister’s mother in law was successfully taking risperdal for dementia and irrational, aggressive behavior for the last 6 weeks. She was 95 and lived in the home with my sister (and our elderly mother). She was doing really well on the drug and her mood swings had evened out. This week she had a sudden stroke (one of the risks of the drug) and died yesterday. She was 95, so who can say if it was a result of the medication. Her quality of life the last 6 weeks on the drug was good.</p>