DEAR DR. GOTT:
Please give your opinion on Seroquel being prescribed to a patient with dementia. I’ve heard it is a dangerous drug when given to the elderly as it can cause death.
Also, should this drug be given long term?
DEAR READER:
Seroquel is an anti-psychotic medication used to treat conditions such as bipolar disorder. It is not approved for behavioral problems related to dementia. Black box warnings for elderly patients with a dementia-related psychosis indicate an increased risk of serious side effects, including pneumonia, heart attack, stroke, and death.
The product is available in doses from 25 to 300 mg tablets or capsules by prescription only. When the drug is prescribed for the elderly, the recommended initial dose is 25 mg daily. Contraindications are noted for those individuals with a history of hypertension, stroke, thyroid disorder, diabetes, high cholesterol, seizures, or heart attack.
Side effects can include fever, sweating, uncontrolled muscle movements, severe headaches, visual and gait disturbances, and more. Be sure to speak with the prescribing physician should any symptoms occur.
Seroquel XR extended release tablets also contain black box warnings because of an increased mortality rate in elderly patients with dementia. XR is indicated for the treatment of schizophrenia, a name given to a group of mental disorders in which a patient loses touch with reality and is unable to think or act in a rational manner. The condition is often treated with tranquilizers and specific drugs to lessen the degree of depression. Extended release tabs are not recommended for the elderly.
Adverse reactions include dry mouth, dizziness, orthostatic hypotension, constipation, a feeling of sedation, and more.
There are a number of interactions with this drug. Be sure to advise your physician of any medications you are taking to assure there will not be a negative response should he or she choose to prescribe Seroquel XR.
The long-term effectiveness (more than six weeks) has not been fully evaluated. All prescribing physicians should re-evaluate patients on a regular basis.
You are correct that the drug can be dangerous for elderly patients with dementia. I can only hope the prescribing physician fully researched all the options before prescribing it and that the dose is a reasonable one.
All patients regardless of age that are treated with anti-depressants or anti-psychotics for any condition should be carefully monitored for negative alterations in behavior, especially during the early stages of a new medication. Family and caregivers must be observant and should report those changes accordingly
If you continue to have unanswered questions and have the legal right to be involved with the care of the individual in question, return to the prescribing physician with a list and request answers. If you remain dissatisfied, seek a second opinion.
To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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