Alzheimers and sexual behavior: Any suggestions?

My husband has always had a healthy sexual desire, but with LBD it seems to be quite enhanced. A psychiatrist suggested that this is an important way he feels connected and one of the few situations left that he can control. However, as his LBD hallucinations progressed from seeing calm people, animals, or hearing soothing sounds to much more frightening situations such as "killers" everywhere - even at home - battlefield sounds (he is a veteran also diagnosed with PTSD) - of guns/bombs/screaming, etc., creepy insects in our bed and on the floors, we needed more help to calm the visual and auditory disturbances. We were prescribed seroquel at 12.5 mg to take at bedtime. He was resistant to taking it because he also began to not trust me or anyone else in any situation. Things were fine until around day 25 of taking the medication. He was asking for sex when our grandchild was in the bed beside us or saying "I want to screw" in front of my dad and so many other inappropriate situations 24/7. He became hyper-sexual snd it became out of control. Since he didn't always recognize me, I became afraid of potential legal issues in the making if he asked the wrong person for sex. He would wake me up at all hours of the night, and many times he did not recognize me. I began to feel used, cheap, tired, and it was taking an emotional toll on me and frustrating him. Then, of course, when we did have sex, he didn't remember it later or the next day. It took a bit, but finally I realized it was the seroquel he had been taking. (It takes around 6 weeks for it to kick in.) We began to gradually decrease this medication until it was stopped, and even though it was a very low dose, stopping it has helped the situation tremendously. He still has desires but they are manageable, and easier to control. He still has a hard time remembering sexual activity but will take a "not now" or "tomorrow" much calmer. The problem is that we are back to the hallucinations, and the meds to help them in an LBD patient are very few. It is a tough situation and one that makes choices for controlling things difficult.
On a side note, at Mayo Clinic, we have repeatedly been asked in evaluations if there has been any inappropriate sexual behavior. This may be one of the side effects that is seen in disease progression. So sorry that I can't help more, but I do understand this issue. God bless you as you navigate through this long, arduous journey. I hope others have suggestions that may help. You definitely are not alone in facing this situation.

Thank you so much for your thoughtful reply. None of the meds he is on would cause this behavior. It is just one of the awful side effects of alzheimers. I will certainly watch for any med changes that might make this issue worst. Nice to know that I am not alone. I am exhausted and don't know how to deal with his frustration. My lack of sleep isn't helping either.

Perhaps speaking to his psychiatrist or neurologist and some type of anti anxiety medication, or at nighttime, something to help him sleep? Everyone is so different and responds differently to medications. There aren’t a lot of dementia medications, but there are a lot of meds that are used off-label that can help with different behaviors. The key is finding a doctor who is willing to work with you in finding what works and at what dosage.

Thanks so much for chiming in. We have been in contact with the psychiatrist. He was on an ant anxiety med that helped particularly with his startle effect. When the sex stuff started he had to come off that and was put on another medication. The doc said he could not take a stronger dose... the side effects would be worse than the behavior. We are planning on talking to our GP in a couple of weeks when we have an appointment. Seems to me there has to be something that would help us.

@terrilynne, how are you doing? Any updates to your husband's medication or behavior?

I am hanging in there. No changes in meds. Behavior is a bit better. He has been on the med for months. Maybe it has taken that long to help. Still a major issue for me but more manageable. At least for now. Thanks for asking.

It seems like with a lot of meds it takes a very long time for the effects to show up, and also in my experience, strangely, the effects may be different at 5 weeks than they are at 12 weeks etc. I hope you can get his doctors to listen to you and get more help. It's not right that you should have to live with this. Would sharing this thread with them help them see how much difficulty this is causing? I know doctors only have a very limited toolbox sometimes, but also sometimes honestly they can be kind of blind to how bad things are. They aren't the ones living with this every hour of every day!

I will try communicating with the doc again. He didn't feel like he could do anything else to help. I feel so lost with this.

I did a search with the words
hypersexuality in dementia
and some sites that came up were:
https://casereports.bmj.com/content/2015/bcr-2014-207864
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980403/
https://www.psychiatrist.com/pcc/neurologic/dementia/hypersexuality-and-dementia-in-long-term-care/
May or may not be relevant to your situation.

Fascinating. Oly read one so far but will read them all. Our situation is different from that one but all information is welcome. My hubby is on several meds. I am not sure about the risperidone. They have so many different names for the same drugs these days. I'll check it out. Thanks so much!