1. Mjaqmac

    Mjaqmac Registered User

    Mar 13, 2004
    939
    #1 Mjaqmac, Feb 17, 2005
    Last edited: Apr 3, 2005
    Can anyone tell me where to find help with medical advice? I am trying to find out what relation the neurolyptic drug has on the respitorary system? And if it is safe to be given to someone with a chronic chest disease?

    Thank you.
     
  2. storm

    storm Registered User

    Aug 10, 2004
    269
    notts
    dear magic, I typed in seroquel and dont like the sound of it at all, it mentions concerns in using it with people who have A/D and also about diabetis hasnt your mum got this? why are they prescibing it? It doesnt mention anything i can see about chest infections,it does mention problems with over heating and blood pressure.love storm
     
  3. bjthink

    bjthink Guest

    Magic, my mum is on Seroquel, which is also known as Quetiepine. It's an anti-psychotic and is thought to be of help to those with dementia who are showing increased aggression and some psychotic symptoms.
    I copied this for you. There's no mention of respiratory illness:

    SEROQUEL should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease or conditions which would predispose patients to hypotension (dehydration, hypovolemia and treatment with antihypertensive medications).
     
  4. Mjaqmac

    Mjaqmac Registered User

    Mar 13, 2004
    939
    Thanks Storm and bj, mum doesn't have diabietis but has ischemic heart disease.
     
  5. thompsonsom

    thompsonsom Registered User

    Jul 4, 2004
    97
    halifax
    Hi Magic

    mum in law is prescribed quetapine she takes 3 25mg a day and she has heart problems having had a bypass some years ago and suffers from angina. The tablet does not seem to have had any detrimental effect to her heart problems but has been a great help with the aggression caused through AD.
    Hope this helps somewhat.

    jan
     
  6. bjthink

    bjthink Guest

    I can vouch for quetiepine, too. It really helps to keep some small rein on my mother's psychosis, and that means that she can be more cooperative (if she chooses!) and therefore get more from the help she receives.
    I know that there's a certain caution around its use, but it's apparently the best thing to use for psychosis in dementia, and has fewer side-effects or dangers than any other known antipsychotic.
    However, her psychiatrist won't increase the dose she's on as he says if he does the AD will accelerate. He's performing a careful balancing act, and although when she's at her psychotic worst I truly wish something more could be done to calm her down, I think he's doing as good a job as he can
     
  7. Katy44

    Katy44 Registered User

    Sep 14, 2004
    134
  8. bjthink

    bjthink Guest

    #8 bjthink, Feb 18, 2005
    Last edited by a moderator: Feb 18, 2005
    It seems to confirm what my mother's psychiatrist has told me.
    But can I just rant about the often poor quality of BBC reporting, or in this case it may just be the vagueness of the original study - although I doubt it. NOWHERE in the piece did anyone mention DOSAGE ie how much quetiapine, or placebos, or rivastigmine was given each day.
    Secondly, in my rant, I have to say how sloppy I find it that the various forms of dementia should be 'rolled up' in this way, as if they were all the same, coming loosely under the heading 'Alzheimers'.
    What my mother's psychiatrist said was very specific. He said that the Alzheimer's component of my mother's mixed dementia might be accelerated by an increase in quetiapine, but that that the drug would help her underlying psychosis and aspects of her vascular dementia.
    I'm going to see if I can find the original research, to see if it's any more reliable than what the BBC's cub reporters are telling us. The sample certainly seems far too small to draw any real conclusions. With only 30 subjects in any group, any odd reaction in one patient would show up hugely to skew the result.
    Will now go check out the BMJ online!
     
  9. bjthink

    bjthink Guest

    OK <phew!> back from my perusal of the BMJ article.....
    All the subjects, for a start had 'a diagnosis of possible or probable Alzheimer's Disease'. The terms 'dementia' and 'Alzheimer's Disease' were used, from the initial specificity of this mission statement, interchangeably throughout the research report <tut tut!>
    And all subjects in the research were suffering from SEVERE dementia.
    In the end, 26 were on quetiapine, and 29 on the placebo (along with 25 on the 'typical' antipsychotic which has the known side effect of contributing to strokes. Quetiapine is an atypical antipsychotic)
    The dose was 100 mg per day quetiapine, increasing from 50mg from week 12 to week 26.
    So what, in summary, does the research paper say?
    It says that in SEVERE stages of ALZHEIMER'S DISEASE, on a small sample basis, the MAXIMUM dosage of quetiapine can appear to worsen the condition, and doesn't apparently help with agitation either. We are talking here about those admitted to Nursing Homes because of the severity of their AD.
    The ones who did best were those on placebos, and this is accounted for by the Hawthorne Effect - people like to take part in social activities, even if they're research projects, as it gives them an outlet for their sociability, and therefore they improve.
    So, in summary, this paper has little to say to us, the in-house carers looking after those with moderate dementia, which may not be 100% Alzheimer's, and trying to deal with aggressive behaviour for which a smallish dose of quetiapine has been presecribed.
    It's very specific paper targetted to the medical profession, and basically saying that when Alzheimer's (only) becomes severe, don't put your patients on anti-psychotics, typical or atypical, because at that stage, they really won't help, and maybe they'll even hinder.
    It's not quite what the BBC is trying to make it out to be, is it? Ah well. Seek the sensational headline was always the motto of the red-tops. I, for one, hate to see that callous and cynical disregard for the whole truth moving into the BBC agenda. :(
     
  10. Mjaqmac

    Mjaqmac Registered User

    Mar 13, 2004
    939
    Katy, brilliant! This is just the sort of thing I was looking for and the links are excellent. Thank you Sherlock!

    Thanks also bj for all that info.
     
  11. Chris

    Chris Registered User

    May 20, 2003
    243
    Alzheimer's Society statement

    The Alzheimer's Society has issued a statement about Seroquel (Prof Clive Ballard is also the Director of Research for the Society). More research info on the RESEARCH section of their website - of which this Forum is a part. (for those who've come straight to TP !!) .

    Here it is -
    Research in the news

    Drug prescribed to dementia patients accelerates cognitive decline
    Alzheimer’s Society comment on research by Professor Clive Ballard et al published in the BMJ on Friday 18 February 2005.

    Quetiapine (Seroquel)
    Research by Professor Clive Ballard suggests that suggests that quetiapine (Seroquel), a drug commonly used in nursing homes to combat agitation, could significantly speed up the rate of patients' decline.

    All too often we hear of people with dementia being prescribed powerful sedative and neuroleptic drugs (also known such antipsychotics) to treat behavioural symptoms such as agitation, wandering and aggression.

    The Alzheimer’s Society strongly believes that sedation is not the answer. Instead people should be encouraged to understand or investigate the cause of difficult behaviour – for example, distress, feelings of humiliation or fear.

    Three-quarters of people living in care homes will have Alzheimer’s disease or another form of dementia, yet only ten percent of care home staff will have received specific dementia care training. Evidence suggests that training health and social care staff improves their understanding of communication problems and reduces the need to use neuroleptics.

    The Society welcomes Professor Ballard’s research and hopes it will strengthen calls for a more person-centred approach to caring for people with dementia and more appropriate training for care staff.

    Neil Hunt
    Chief executive

    18 February 2005
     
  12. bjthink

    bjthink Guest

    Oh dear, sorry, I find myself at odds with the Alzheimer's Society. The use of the word 'powerful' is emotive and unnecessary. The 'power' of any drug depends on the dose given.
    Anti-psychotics, like quetiapine, are given to those in our society suffering from psychotic conditions, like paranoid schizophrenia. Would the AS sanction no medication for those people, but instead suggest more effort be made to educate those with these serious mental conditions into understanding and investigating the cause of their difficult behaviour? Psychosis is a condition in which insight is not present, so I don't see how that stacks up.
    And why this either/or approach? Surely talking/helping therapies can be used in conjunction with medication, as they are in the treatment of psychosis in general?
    There is another danger in going down that route. I believe, as do many who care for someone with any dementia presenting with paranoia, delusion and overt aggression, that the state is looking at dementia as a social/behavioural problem which can be cared for by Social Services, rather than a medical condition. I believe that my mother's condition is medical/psychiatric and should be cared for totally by the NHS.
    Lastly, while the research involved fewer than 27 people with severe Alzheimer's Disease (for whom quetiapine is generally not recommended) living in care homes, the message of this research sent to end-of-tether carers like myself is that we, too, should resist the use of quetiapine for those we care for in their/our own homes.
    Without quetiapine my mother would be totally unmanageable, and would have to be admitted into a hospital or nursing home. Quetiapine eases her paranoia and delusions.
    Yes, I believe that responsible campaigning organisations like the AS should send out the message that everything humanly possible should be done for dementia sufferers in care homes rather than turning them into over-sedated zombies who can then be 'managed', but that's a completely different issue from the one investigated by this particular team, who were themselves, for the purpose of this research, sedating the care home residents with two very specific drugs in order to discover if either of them work in severe cases of Alzheimer's Disease. THAT was what this research paper was about.
     
  13. allenb

    allenb Registered User

    Feb 22, 2005
    1
    Tallmadge Ohio
    Seroquel

    To even begin to discuss the benefits my mother gained from this drug would take countless hours. I would be more than happy to relate any information that would possibly help others suffering through what my mother did for 5 1/2 years. Mom did have seizere issues that required medication that related directly with her use of Seroquel, but the benefits for her far outweighed the negatives. I am happy to share any information with anyone who would benefit with knowledge of my mothers experiences.
     

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