DEAR DR. GOTT: Please tell me why doctors prescribe Seroquel to elderly dementia patients when warnings about the drug clearly state that it is not for the elderly who suffer from dementia. One patient on the medication at an assisted living facility almost stopped eating completely and was rushed to the hospital very ill. She was then taken to a nursing home in hospice care and did well but is now back on Seroquel and is clearly losing weight again. It seems the patients on this drug are like zombies and do not have an appetite.
DEAR READER: Seroquel is an anti-psychotic used to treat schizophrenia in those individuals – believe it or not – from the age of 13 and up and for bipolar disorder in those 10 and older. It may also be combined with anti-depressants in adults. It is not recommended for use in the treatment of any psychotic conditions related to dementia, as the medication can cause pneumonia, heart failure and even sudden death.
Warnings indicate the medication should not be taken in doses greater than that recommended by the prescribing physician or for longer than necessary. This is because long-term use can result in an irreversible movement disorder. The medication should be discontinued if there are signs of irritability, agitation, aggressiveness, hyperactivity, more extensive depression, suicidal thoughts, and for other reasons. Seroquel can cause hyperglycemia (high blood sugar) so any symptoms such as excessive hunger, increased thirst or urinary output and weakness should be reported.
Those individuals on the medication but not in nursing homes should avoid drinking alcohol or becoming dehydrated or overheated during exercise. Everyone on the drug should be aware that Seroquel can impair thinking and reactions.
Some of the most common side effects include fatigue, headache, dizziness, drowsiness, lightheadedness, an increased appetite and weight gain. You indicate the person in question is losing weight, not the reverse. So, this may go against the drug being to blame. I use the word “may” because each person reacts differently to almost any drug so I cannot rule this out completely.
This brings me to an important question. Is this person a friend or relative and do you have power of attorney? I can appreciate you being concerned but you may be limited in what you have a legal right to do. The doctor and staff in charge are bound by HIPAA regulations and cannot speak with you about her unless documentation permits. Do you know the family? Sometimes non-family members are more observant than are those more closely involved. If given the opportunity, share your concerns but don’t be offended if they choose not to take action.
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