Transitions..... Medications for Behavioral Symptoms

Posted by Debby - @tavi @tavi, Oct 6, 2016

Does anyone have experience with medications commonly used to treat behavioral and psychiatric symptoms of Alzheimer's disease? Our home health nurse recommended (and Dr. prescribed) starting my husband on a very low dose of quetiapine (Seroquel) for agitation and depression. I think I understand why we are moving to the antipsychotic meds -- He is depressed as well as becoming more and more anxious, agitated and upset. He is unaware of how his behavior changes throughout the day - most alert when he first rises leading to lots of confusion/anxiety from 4 pm to 8 pm. Also, when he finally settles in bed he does not sleep more than 2 hours at a time during the night without having night sweats requiring a complete change of clothes.

Regardless of the effectiveness of the medications, I'm facing some pretty tough issues and decisions. I can try to get more in home care but I am also questioning my original plan for home care. Is staying in our home the best for my husband or would he feel more secure and stable in a memory care setting (as well as get more social interaction that may help the depression) -- I have not yet visited any facilities near our home but will be doing so in the next few weeks. I know that any transition will be hard on him - whether it is bringing more people here into our home or moving to a memory care facility ..... appreciate any and all perspectives.

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@caregiverwife1

need advice. my husband has had alzheimer's for all of 15 years. he is at home and now it is 24/7 care. recently his doctor prescribed seroquel for agitation and sleep but i see him more confused and anxious. sleep is better but daytimes are more challenging. what is a safe alternative to seroquel? we already listen to lots of music and do as much as possible without drugs. but i'm looking for something to calm him when nothing else will--without being dangerous.
any advice?

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Good morning @caregiverwife1 I am Scott and I was my wife's caregiver for just over 14 years.

I'd like to echo the earlier advice that you definitely check with your husband's doctor on his medications, suggestions, etc. For the last years, my wife was on a cocktail of over 8 medications and even that incredible combo never really alleviated her high levels of anxiety.

I also found you comment about music very interesting! In my wife's case music, TV, radio, etc. only made her anxiety worse so we resorted to silence for her. Again, in her case, the only auditory stimulation that didn't cause problems was when we'd talk. Strange how different human brains are! As my wife's neuro-oncologist said to us "we really don't understand all that much about the brain, and when it's broken we REALLY don't know how it works."

Strength, Courage, & Peace

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@hopeful33250

Hello @caregiverwife1 and welcome to Connect. It sounds like you are an experienced caregiver as you say that your husband has had Alzheimer's for 15 years now.

I am sorry to hear of his increased anxiety recently. I'm sure that neither of you needs that. I see that @janet7 has given you a good suggestion to call his doctor, As you have mentioned the use of Seroquel is relatively new, perhaps the doctor can suggest an alternate med or even an additional med that will help with this daytime agitation.

I would also like to invite Julie, @billchitwood, to this conversation as she has been in contact with her husband's doctors to adjust meds just recently.

I certainly admire your use of non-medication treatments like music and I'm wondering if you would share other activities you have tried to reduce the symptoms of Alzheimers?

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After being on the Seroquel for more than a month it looks like it has finally kicked in. During those months it was terrible. He showed anger and paranoia almost daily. He was so up and down it felt like I was living with a yoyo. The last few days have been amazing (other than he now wants me to watch movies with him - same ones over and over!). But he is happy.

Also during that time he was writing family members saying we were holding him hostage and he needed to be rescued and giving out financial information. Some responded almost as if he had won the lottery! Just wave a little money around and weird things can happen. Didn't occur to him that he was trying to give away our life savings and what we need to live on.

Years ago a friend had health issues and her only child, a son, convinced her to sign everything over to him and he would take care of her. She did - he got the money and disappeared and she went on welfare. We had an insurance agency and sold annuities and it always amazed us how many children viewed their parent's money as theirs - often saying that since it was their inheritance they needed to be in control. Fortunately my kids keep saying for us to spend it and enjoy it - that we earned it.

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@caregiverwife1

need advice. my husband has had alzheimer's for all of 15 years. he is at home and now it is 24/7 care. recently his doctor prescribed seroquel for agitation and sleep but i see him more confused and anxious. sleep is better but daytimes are more challenging. what is a safe alternative to seroquel? we already listen to lots of music and do as much as possible without drugs. but i'm looking for something to calm him when nothing else will--without being dangerous.
any advice?

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One of the most calming things I have seen for my husband is a robotic pet! I have been amazed. My very intelligent husband loves his “Puppy” and will sit quietly, petting & talking to it. ( Even tries to feed it) It’s battery operated and wags its tail, pants, turns its head, blinks, & barks. He doesn’t like the barking, so I turn that feature off. Ours was provided through a grant via the local Area Agency on Aging. They are favorites according to the caregivers in our support group. Better than many medicines.

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Moving to a new home really set back my husband. He hates any changes and a new home, new surroundings, new bed, shower, etc. caused great anxiety. It took close to a year before he showed some adjustment. By the way, there were no medication changes during this time. I just want to warn any caregiver contemplating a move that it will be difficult.

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Actually, Will loved the move from Illinois to North Carolina and couldn’t wait to get a house. He has loved this home and worked very hard to make it his own. If he were healthier, we would have stayed much longer. The home is just what he always wanted and the warmer weather we just don’t have in Illinois. Of course, his Dementia was no where near what it is now and we need to get back to family and friends. He is very unhappy with the move, but he agrees we need to be back with family. He knows we need help and support and we don’t get it here.

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@pattyinal

One of the most calming things I have seen for my husband is a robotic pet! I have been amazed. My very intelligent husband loves his “Puppy” and will sit quietly, petting & talking to it. ( Even tries to feed it) It’s battery operated and wags its tail, pants, turns its head, blinks, & barks. He doesn’t like the barking, so I turn that feature off. Ours was provided through a grant via the local Area Agency on Aging. They are favorites according to the caregivers in our support group. Better than many medicines.

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I think your suggestion to get a mechanical dog might be helpful. We love watching dog shows on TV and even thought of getting a dog but then we rented an apartment that doesn’t allow dogs, and that was the end. Now with this toy dog, we both might benefit from having it.
May I ask where you bought it and the name of the manufacturer?
Very excited to buy one, thank you!

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I am going to ask his doctor about Seroquel. Glad the meds are helping Bill. What a relief for you all!
You know, families nowadays have children that will even kill their parents to get their money, and they do! I am sorry for the mother whose son stole her money. But to me, the worst part is the love and respect she lost somewhere along the way. If I was that woman, it would hurt me more to know the love and respect I thought he had for me was gone. It would be a heartbreaker for me and the loss of my money would not be that important.
But that’s me.

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The doctor put Bill on Seroquel about a month and a half ago due to severe anger issues - it seemed to just kick in this past week and what a difference it has made so far! They also doubled his Sertraline and changed it to morning. He had been taking Sertraline since 2014 so I don't think that made the noticeable difference. I had read that it sometimes takes the Seroquel a month or so to help.

Bill's behavior before it kicked it was so bad that I really didn't think I could keep us living with our daughter. It was one thing to have him cussing me out but to listen to him go after her was heartbreaking. Now he is loving. I only pray that it lasts. He was always hard to live with unless he got everything his way. But with his dementia it is no longer safe to give him 'his way', which helped to trigger the severe anger (aided by the dementia).

So thank heavens for the doctors adjusting his medications!

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@janet7

I think your suggestion to get a mechanical dog might be helpful. We love watching dog shows on TV and even thought of getting a dog but then we rented an apartment that doesn’t allow dogs, and that was the end. Now with this toy dog, we both might benefit from having it.
May I ask where you bought it and the name of the manufacturer?
Very excited to buy one, thank you!

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They are available on Amazon. Ours is a Joy To All golden puppy. They also have cats for cat lovers.

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@pattyinal

They are available on Amazon. Ours is a Joy To All golden puppy. They also have cats for cat lovers.

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And even a picture of the dog! How adorable and so thoughtful of you! Thank you!!

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