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 Seroquel increasing confusion and agitation? 
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Joined: Fri Oct 28, 2011 1:31 pm
Posts: 29
Post Re: Seroquel increasing confusion and agitation?
My mother took seroquel for confusion and mild hallucinations several years ago, but only for a very short time. She started having very very scary hallucinations and paranoia. She was much better when the medication was discontinued. As a note, she was given a small dose of geodon (another antipsychotic) to help her sleep when she was in the hospital a couple of years ago. She was not able to walk or feed herself until the medicine was discontinued. We stay away from all antipsychotics now.


Fri Apr 06, 2012 11:44 pm
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Joined: Sat Oct 27, 2012 11:12 am
Posts: 10
Post Re: Seroquel increasing confusion and agitation?
I was reading some of these older posts. My husband is on 25 mg of seroquel 1x daily and 10 mg namenda 2x daily. He is doing fine on that and it stopped his hullucinations. I was wondering what NMS is (referred to in several posts) He is taking Cymbalta and was taking it at night when we were in the hospital at the time of diagnosis. This is for pain in his feet - neuropathy. I read that it can cause bad dreams, etc., so I ask the dr at rehab if we could give that med to him in the a.m. and it helped, because he was still dreaming and acting out his dreams, but once we changed I don't think he has done that or not as bad. Makes me wonder if his problem could have been that med all along. I try not to give him any other med with his seroquel except a tylenol once in awhile, other than his namenda.


Sun Nov 18, 2012 10:08 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3176
Location: WA
Post Re: Seroquel increasing confusion and agitation?
NMS is neuroleptic malignant syndrome, a life-threatening condition. It can sometimes occur in PD/LBD patients when they are given certain antipsychotic drugs, especially 'typical' antipsychotics like Haldol. My husband got it from Risperdal but recovered to baseline after it was discontinued. He does OK on Seroquel. The symptoms include severe PD symptoms, like muscular rigidity, fever and altered consciousness as well as other symptoms.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Nov 18, 2012 11:06 pm
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Joined: Tue Jan 29, 2013 10:49 pm
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Post Re: Seroquel increasing confusion and agitation?
My husband has just begun a low dose of Seroquel, 12 and 1/2 mg twice a day, for insomnia and agitation [hitting, kicking, etc.]. He may be sleeping better but the agitation is definitely not gone. In fact it may be worse! There is talk of adding Atavan into the mix but I have read that Benzodiazopines are not good at all for LBD? Any ideas? For sleep, Trazodone and Melatonin were tried already. Trazodone was horrible and Melatonin sort of worked but only for a few months.


Tue Feb 12, 2013 12:55 am
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3113
Location: Vermont
Post Re: Seroquel increasing confusion and agitation?
If there's one thing consistent in LBD it is the inconsistency in how LBD patients react to the same medication. As many have said here before, ask your LOs dr. to try only 1 med change at a time, and start out with a very low dosage just in case your LO has a bad reaction to what is helpful to others. It is so unpredictable, it seems, how any one individual reacts so you want to avoid making things worse. A peaceful day to all, Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Feb 13, 2013 9:20 am
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Joined: Mon Oct 15, 2012 8:46 pm
Posts: 21
Post Re: Seroquel increasing confusion and agitation?
hi, my father has in the last few weeks also started to display signs of agitation and anxiety, symptoms he never had before. I don't think its the serquel as he has been on that for at least year and a half. Could it be the Execlon patch? he started on the 4.6 dose last October and it did wonders for him. However when the dosage was increased to 9.5 it seemed to coincide with a change in him. I've searched the forum but can't see anyone else who's experienced a reaction to Execlon...any ideas? his Consultant today suggested he may have an infection so she wants to get his bloods tested first before making any changes. Has anyone any advise? He has become very distressed and difficukt to manage in the last few weeks. thanks


Thu Feb 14, 2013 3:20 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3176
Location: WA
Post Re: Seroquel increasing confusion and agitation?
My husband started the Exelon patch in March of 2007 and showed great improvement at the 4.6mg level but no improvement when it was increased to 9.5mg, which he has been on ever since. His agitation and anxiety [we've been told] are largely due to his high doses of Sinemet rather than the Exelon patch but every Lewy is different in his/her reactions to meds. If you find that the Exelon is causing it, please tell us because we may want to discontinue it, as he is in the late stages of the disease and it probably isn't doing anything. His neuro said we could d/c it two years ago but I was a little afraid to.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Thu Feb 14, 2013 3:37 pm
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Joined: Mon Oct 15, 2012 8:46 pm
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Post Re: Seroquel increasing confusion and agitation?
Hi Pat, I'll let you know how it goes. Blood tests come back on Wednesday so they'll know more then hopefully. He's been on a consistent dosage of Sinemet for the last 5 years so I don't think it could be that affecting him. Seems strange the first patch did wonders for him but that an increased dosage could have an opposite affect?


Fri Feb 15, 2013 4:29 pm
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Joined: Mon Oct 15, 2012 8:46 pm
Posts: 21
Post Re: Seroquel increasing confusion and agitation?
Since my last message things have gone from bad to worse. Last Thursday night he was up all night banging doors, hitting walls etc. An increase in seroquel of 12.5mg was adminsitered the next day, in the morning and at night. It seemed to work well at the weekend and he was back in good form. However this morning his carer rang me to say that she found him trying to get out of the window. When she pulled him back in he grabbed her by the arm and dragged her from one room to the next. he also lifted the TV out of it. She was very upset and her arm was red raw after it. The nurse came shortly afterwards and suggested we take him off Exelon for the next few days and monitor his behaviour. however she also feels a week in respite care might be good for him so that they can assess him properly. I'm wary of this because my first instinct is to think that if he gets agitated in care they might dope him up to keep him quiet which could end up leaving him in a vegetated state. I don't what to do. Myself, my siblings and carers are finding it increasingly hard to manage him but I don't want to just give in and let him go into care for any length of time. They have reassured me that its only for a week but I'm worried it could turn out to be a disaster. I suppose its impossible to know what to do, we just have to go on instinct and do what we think is best for our LO.


Wed Feb 20, 2013 1:34 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3176
Location: WA
Post Re: Seroquel increasing confusion and agitation?
My husband gets 50mg Seroquel twice a day and is not 'doped up'. Face it---your husband's current behavior [believe me, we've been there!!] will not be tolerated in most facilities and then where will you [and he] be?

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Feb 20, 2013 3:22 pm
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Joined: Tue Aug 30, 2011 1:42 pm
Posts: 107
Post Re: Seroquel increasing confusion and agitation?
Interesting thread here. My mother has tons of anxiety and tons of fear. She is taking Stalevo and Seroquil. I can honestly say that Exelon was a disaster for her. My mother is both bi-polar and has Lewy (or perhaps Parkinson's that has turned to Lewy - but the large motor version, not the shaking type). Anyway - the first two doses of Exelon worked very well for my mother (although she got manic high and wanted to buy a house and new furniture etc.) The third time it was upped she got hostile and mean and nasty manic and we actually had to request, my sister and myself, to have her removed from it for awhile. We have tried to reintroduce it twice now (most recently in pill form) and she gets nasty and paranoid and abusive to the assisted living people (she hit an aid once). The seroquil has been wonderful. It helped a lot with the hallucinations. I don't think it is helping, at least not anymore, with the lucid dreams. I wish I knew what would. We have allowed a reintroduction of a benzo at night (she was seriously addicted to benzos a few years back) but I am not sure that is helping either. I wish that I could get her to give up the Stalevo (carbadopa levadopa). I wonder if it is contributing to her problems (but she would probably have to give up mobility, but I have noticed that she is especially bad during the time period about a half an hour before her next Stalevo is due and it lasts until about an hour after she takes the next dose). She took Sennamet for awhile, but it caused her problems. She also took a variety of other drugs like Gabapentin (which I thought worked well, but the doctor didn't think it was a good drug for Lewy), ambien, trazadone, and a plethora of antidepressants. Her memory care assisted living facility is getting tired of her and her behavioral problems. They have indicated that they will likely be asking that we take her to a different facility soon. Getting so tired of this - feeling awful for my mother who doesn't seem to be able to control her reality or her behavior.

Liz


Thu Feb 21, 2013 2:58 am
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Joined: Mon Oct 15, 2012 8:46 pm
Posts: 21
Post Re: Seroquel increasing confusion and agitation?
Pat, my father is on similar amounts of Serquel at home. I suppose what I meant was that we were worried that if he became agitated in the care unit that they might use non LBD meds to calm him down. I was just worried that he might get more sedated on them and lose what ever reality he had left. I may have watched too many movies. Tomorrow is a difficult day for us, it's his first day to go into respite care. Although its only for a week we still find it difficult to let him go.
Liz, sounds like you've had a tough time. To see our LOs become aggressive is hard to deal with. We were hoping our father could stay home for longer but he has just become too difficult to manage. All we can do it hope their new meds help them to calm down and become more content.


Sun Feb 24, 2013 7:27 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3113
Location: Vermont
Post Re: Seroquel increasing confusion and agitation?
It is hard to move our LOs to a new place. It's really hard. But, we do it out of love and because we just can't handle it ourselves any longer or their decline is so sudden and drastic that there is no way to let them continue to live in their home. Just do the best you can with the situation, take care of yourself, and above all, don't feel guilty. There are not many of us who place a LO in a facility "just because" or because we are mean. Take a deep breath, get a good night's sleep, and continue to advocate for your LO's care, even if they are no longer able to live in theirs or your home. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sun Feb 24, 2013 9:59 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3176
Location: WA
Post Re: Seroquel increasing confusion and agitation?
Just a note about the Exelon patch: At the seminar yesterday, I asked about discontinuing it in late stage LBD and the neurologist stated that, while there are no controlled studies that she knows of, anecdotal evidence shows that people don't do well when it is discontinued and often do not return to baseline even after restarted. So....I guess we'll be staying on it for the time being.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Feb 24, 2013 10:11 pm
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Joined: Mon Oct 15, 2012 8:46 pm
Posts: 21
Post Re: Seroquel increasing confusion and agitation?
Thanks Pat, I had been concerned about that. My sister believed it was the Execlon patch that was causing dad's aggression and sudden cognitive decline. However I was anxious we didn't touch it in case it did irrevocable damage. I'm comforted now that we are doing the right thing and keeping patch on.


Mon Feb 25, 2013 3:27 pm
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