Re: Progression of LBD? Sundowners? Or Seroquel?

May 29, 2008

Hi All,

Meri Jane is right: Seroquel can have the effect she described, but observing

that response should be a " red flag " for us. While there are guidelines, dosages

are supposed to be based on: symptom(s) being treated; age, weight, gender,

overall physical health, severity of mental impairment, timing and dosages of

other meds, and several other factors. Seroquel is not intended to be used as a

sleeping pill or a tranquilizer that will " dope up " our LOs. If that usage is

observed in a facility, the DON and MD should be called right away.

Properly prescribed, it can " smooth out " such symptoms as aggression, extreme

restlessness, hallucinations and agitation. My mom went through several periods

in which the dosage needed to be decreased. This is usually done in stages - as

is raising the dosage. The accepted titration increments are 25 mg, but my mom,

like many with LBD, is quite sensitive to the action of medications, so we have

raised or lowered the dosage by as little as 5 mg at a time. She was at one time

extremely agitated and combative: that rarely happens now. So over the course of

several years, as her behavior changed and she became physically and mentally

more frail, we have decreased from 250 mg to 45 mg. Early on, I felt she was

overly groggy, had problems walking, and had slurred speech. The MD willingly

lowered the dosage, so Mom could be calm but not " loopy. " The general goal for

many meds is to give a sufficient amount to address the problem, but not to

over-medicate to the point a LO has

trouble communicating, walking, etc. If the dosage is correct for the

individual, but they appear overly medicated, " split dosages " can be arranged.

Depending on the problem and its severity, some can be given pre-bed, some AM

and some mid-day. " Dose-loading " - giving the whole dosage at once - works for

some but not all.

Again, observation; ongoing communication with the MD; and proper dosages are

vital for successful treatment with Seroquel or any med. Discontinuing a useful

medication that our LOs can tolerate is not always the solution - the solution

may well have to do with finding the correct dose and dose-time.

Lin

Meri Jane wrote:

I know you are probably getting lots of different opinions on this

subject and since everyone responds differently to meds and all, this

should be so, but just an FYI, my Dad is on Seroquel and a while after

they give it too him he gets loopy/sleepy and his speech gets sounding

much like a drunk. He also has a hard time walking by himself and in

fact since I visit him at the ALF on my way home from work, I had to

ask them to give him this med a bit later in the evening as I could

not visit with him when he gets like this. He makes no sense when he

talks when he gets loopy from Seroquel. It does make them sleepy.

Meri Jane

------------------------------------

Welcome to LBDcaregivers.

May 30, 2008

Actually the Seroquel was given to Dad for both the hallucinations

and help with sleep, he only gets it in the evening. He was getting

Trazadol for sleep but they cut that out for just the Seroquel as it

works great alone for him in the evenings and yes, everyone is

different. He does great during the day and needs help with sleep

or he will pace all night long. The less meds he has to take the

better so I don't mind that the Seroquel makes him sleepy, just want

them to wait until after my visit. The good night sleep he gets on

it makes him a happier person the next day. He still has nights

when he doesn't sleep so well and the next day he's just a bear.

Yesterday was a good example, and those days are so hard especially

when I have to take him to doctor's appts. I hope my response on

this was not taken wrong, I feel like I just got a major spanking.

I am very new to this LBD stuff, but feel Dad is doing pretty good

right now and better with the new antiparkinson meds. Still roller

coaster days but I feel so far so good right now. Meri Jane

> I know you are probably getting lots of different opinions on

this

> subject and since everyone responds differently to meds and all,

this

> should be so, but just an FYI, my Dad is on Seroquel and a while

after

> they give it too him he gets loopy/sleepy and his speech gets

sounding

> much like a drunk. He also has a hard time walking by himself and

in

> fact since I visit him at the ALF on my way home from work, I had

to

> ask them to give him this med a bit later in the evening as I

could

> not visit with him when he gets like this. He makes no sense when

he

> talks when he gets loopy from Seroquel. It does make them sleepy.

>

> Meri Jane

>

> ------------------------------------

>

> Welcome to LBDcaregivers.

>

May 30, 2008

Dear Meri Jane,

It's wonderful to hear your dad is doing well with the Seroquel. I think I

totally misunderstood your comments about your father's response to it. So

please accept my apologies: I absolutely intended no disrespect to you or the

care you're providing for your dad. & nbsp;Sero. is a strong med, and & nbsp;and

some of us have found that staff at some places & nbsp;use it for their

convenience, rather than as a useful treatment when properly given. It can also

be given in too large a quantity through no one's fault. My comments were really

meant more as a reminder and a sharing of what my mom has gone through and what

I observe in my work with elders at & nbsp;some other facilities. & nbsp; I do feel

very sorry if any of my words were discourteous or hurtful: again, I apologize

very sincerely. Thank you for your understanding.