quetiapine

[gracey]

My mum has recently been prescribed Quetiapine. I think its because she gets so agitated and is up most of the night. It has made her really drowsy... she can hardly talk in the evening.
I'm a bit worried as I've not read very positive things about this drug. Should I be worried?

 

[Grannie G]

It`s possible your mum is on too high a dose. perhaps you could discuss it with her doctor.

 

[loxandra]

Hi Gracey, My husband is on quetiapine [seroquel]. He was originally prescribed i1tablet 25mg every evening for agitation and nighttime walk arounds but this was too much for him. It knocked him out completely till 2-3 the following afternoon so I only give him half the dose now and he is fine. Sleeps thru the night and wakes up about 9.

 

[diablo]

Mum was on that for about five weeks when her hallucinations were bad. I asked for the dose to be reduced as she was sleeping much too long every day but was told it was the lowest dose they made.

Apparently lower doses in liquid form were possible but the carers weren't allowed to give them and she wouldn't take medicines from me at that time.

I suspect it worsened her condition but cannot prove it of course, though it did get rid of the hallucinations totally.

Try to get her off it as soon as possible and see how she is then.

 

[sistermillicent]

My mum was on quetiapine for a year, it was a godsend as she had been so difficult to live with prior to that and although it didn't make her "fine" it made it possible for dad to keep her at home, and for us to get a proper care package in place.
It made her sleepy, though to be honest that was a godsend too because she went to bed at about 8 and that gave dad time to himself. She often sat with her eyes shut and head in her hands before the quetiapine, and this continued afterwards, but she would occasionally doze off. Mum has always loved sleeping so Dad and I felt this was not something distressing for her.

When mum saw the consultant after a year or so it was a different one, and he changed the medication to risperidone, which has apparently been better researched and proven to have an effect in cases of dementia. I am telling this second hand so don't take this as the absolute last word in drug knowledge!

The risperidone has been okay, mum doesn't sleep so much but she still shuts her eyes a lot. There are more up all night scenarios now too, unfortunately, but for now this is followed by several really deeply asleep long nights.

In the later days of taking it the quetiapine hadn't been so effective in controling the paranoia and resulting violence anyway and risperidone has helped again with that which was the main thing for us.
Pippa

 

[gracey]

Thanks for the replies. It's nice to hear that it has worked for some people. Mum is in a care home. She gets so agitated and has started biting herself. She's on 25mg at the moment. One carer said it would take about 3 months to work! It seems to have made her sleepy straight away. Think I will see if they can reduce the dosage. I was just worried as there is research that says this drug shouldn't be used with people with dementia.

 

[Carabosse]

My mum is on quetiapine, she was put onto it after she was diagnosed with Alzheimers as she was seeing writing on the wall. She has been on 75mg for a while but was dopey during the day so now she is on 50mg and seems to be doing better, although in saying that she is still dopey during the day but i think thats due to the painkillers she is on. Before Christmas she thought there were other people in the room when in fact there was only mum and myself, so might have to consider putting the dose back up but we shall see.

 

[leslee]

My Mam is taking quetiapine although I'm not sure what dose she's on but I suspect it's 75mg as the lower dose didn't work. Before this she was constantly accusing people of stealing from her, dialing 999 at least once a day and believed people were in her house at night. She was always angry, scared and upset. She also made our lives miserable. Now she does sleep more but is a lot happier in herself and has more visitors whereas before people were wary of going round in case she reported them to the police. There have still been odd occasions when accusations have been made but they are not so unrelenting now

 

[Carabosse]

My mum 'fights' the quetiapine as it takes ages to kick in and sometimes it makes her aggressive but not to the point where she is violent or anything, but i have had to call out of hours for advice (not that they are much help).

 

[Nebiroth]

I'm a bit worried as I've not read very positive things about this drug. Should I be worried?

No. Remember that the leaflets that come with drugs are required, by law, to list all of the possible side effects no matter how unlikely.

Though anti-psychotics are generally not recommended for use in someone with dementia, that doesn't mean they are banned. It just means that the prescriber has to take note of the increased risk of stroke - but again, this is a small risk to begin with so even when it is increased, it is still s small risk. It becomes a question of a risk-benefit calculation and if someone is in a constant state of anxiety then that can also be detrimental to their health (mental and physical), it may also mean they may not get the appropriate level of care because what is called "challenging behavior" make sit impossible.

Keep in mind that the internet isn't regulated, so anyone can make any sort of claim they want to. Most people are much more inclined to post up negative experiences than they are positive (if a headache tablet makes you feel sick, you complain: if it just cures your headache, you're more inclined to just accept it did it's job and say nothing). There are also numerous sites that are frankly operated by cranks who make all sorts of claims without any proper evidence. Note that Wikipedia for example is made up entirely of user contributions and thus it cannot be relied upon for absolute accuracy

Anti-psychotics have also had a lot of bad press due to their inappropriate use, usually when they have been used to sedate residents of care homes for staff convenience.

The prescriber will take account of the potential risks and downsides against the benefits and make a judgement. They will also utilise the lowest possible effective dose.

Obviously if you are unlucky and worrying side-effects appear, then you'd need to report this to the prescriber or the GP and in that case it would normally be stopped.

Usually, the beneficial effects of anti-psychotics take some weeks or months to be fully evident, however side-effects can appear much more quickly. Sedation is a common side-effect and it will usually lessen over time as the person builds a tolerance to the drug. 25mg is really a very low dose; my dad was on 400mg daily and he still ended up being sectioned into a mental health unit. The safe adult dosage is actually higher than this and up to 800mg+ are not unheard of.

 

[Boldredrosie]

Quetiapine is an antipsychotic and not licensed in the UK for any form of dementia; as far as I'm aware it's indications are schizophrenia and bi polar disorder only, with a warning that it shouldn't be used in the elderly with dementia-related psychosis.

I would question the doctor who prescribed this medication what his or her reasoning behind it was and what alternatives there may be - medicinal and otherwise - for your relative.

The Department of Health published guidance on using antipsychotic drugs in people with dementia last summer and how to reduce their use -- it's easy to find on the internet and may provide you with some ideas about what could work in your relative's particular case.

These are really serious drugs with the potential to do a great deal of harm in frail elderly unwell people and, IMHO, should only be used when genuine psychosis exists. Otherwise it's often used merely to sedate so that the troublesome behaviour goes away.