My wife is 82 years old and has had dementia for many years. She was diagnosed with Alzheimer’s and given many different medications to try but nothing worked. When she started getting worse her physician prescribed Seroquel.
About four or five weeks into taking the medication, she became really confused. She would wake up at night and want to go home without realizing that she already was home. It scared me so much that I was afraid to go to sleep in case I didn’t hear her get up.

After reading your column, I took my wife off the Seroquel and noticed a dramatic change within a week. She has told me that she is feeling better than ever. She now takes 3 mg of melatonin which helps her sleep all night and she has no more confusion during the day.

DEAR READER:
I am glad to hear that my column helped your wife; however, if she has dementia, she should never have been prescribed the medication.

Seroquel is an anti-psychotic medication used to treat conditions such as bipolar disorder, not Alzheimer’s. There is even a black box warning stating that it should not be used in elderly dementia patients. Assuming your wife really has Alzheimer’s, her physician made a potentially dangerous error.

You say that your wife is feeling better, no longer confused and sleeping all night thanks to stopping the Seroquel and starting melatonin. If she is no longer having symptoms of dementia, perhaps she doesn’t really have Alzheimer’s.

There are several disorders that can cause dementia and other neurological changes. Vitamin deficiencies, normal pressure hydrocephalus, Alzheimer’s, even depression or sleeping abnormalities and more are possible culprits. Some are reversible, others are treatable but until there is a positive diagnosis, there is no way to knowing what will help her.

I urge your wife to undergo testing to determine the cause of her dementia. She should also be under the care of a neurologist if she isn’t already. If she is seeing such a specialist, ask for a referral for a second opinion. If it was her primary care physician who prescribed the Seroquel, perhaps it would be appropriate to find another since he or she has already shown disregard for medication warning labels.

If symptoms persist, but are mild she may be fine without medication, but be sure to speak with her specialist about this. It is also important that you take proper care of yourself. Providing full time care for a dementia patient can be incredibly difficult. You may find it easier and more rewarding if you bring in occasional help from a local visiting nurse association. This type of organization can provide assistance to the care taker as well as the patient.

To give you related information, I am sending you copies of my Health Reports “Alzheimer’s Disease” and “Medical Specialists”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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.