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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > Is there a med that will reduce agitation in someone who has dementia?
Pharmacy - Is there a med that will reduce agitation in someone who has dementia?
Expert: Mary E Scott, RPh, CGP - 10/27/2009
Question
QUESTION: Hi. My mother has dementia and has lived in an assisted care facility for 5 years. A significant problem has been continued intense agitation and aggressiveness. She has taken Depakote and Seroquel for the last 5 years. She overdosed on Depakote (lost all functioning, hospice was called in). She is taking depakote now 125 mg 2 x daily. She had been taking 150 mg of Seroquel until recently, but because of side effects (extreme sleepiness, loss of balance, loss of brightness), Seroquel was discontinued. Since that was discontinued, she is able to walk normally, isn't somnolent is alert, etc, but agitation is a big issue. Any suggestions? Thanks much! Judy
ANSWER: Hi,Judy,
Is she on any other medications or supplements? I wouldn't really be able to suggest anything without knowing this.Also, does the agitation occur at any specific time of the day? Mary
---------- FOLLOW-UP ----------
QUESTION: Hi Mary--She takes lisinoprol, synthroid, statin, Depakote (125 mg 2x daily), celexa (low dose). W/exception of celexa, she's taken those drugs for years. The agitation/aggressiveness probably occurs any time day of the day, w/exception of the am. That's her best time of day. Giving her Ativan PRN or Seroquel PRN doesn't help agitation. That has been the worst symptom of her dementia. She swings between somnolence/dizziness/falling when getting higher dose of Seroquel and agitation when Seroquel is discontinued. Any thoughts wld be much appreciated.
Judy
Answer
Hi,Judy,
Another question-has she had her TSH level tested recently? Low TSH level may show that she is receiving too high a dose of synthroid which can cause increased anxiety and agitation.
I am not a big fan of prn meds for agitation especially Seroquel or other antipsychotic meds (Risperdal,Zyprexa, Abilify). Nine times out of ten, the prn med is given too late when the patient is very frustrated,etc and then when it doesn't "work" as well or as fast as the caregiver thinks it should, the dose is increased, causing sedation,confusion and risk of falls. In my opinion, 150mg of Seroquel is much too high of a dose in the elderly.
Has a small routine dose of Ativan been tried? Maybe giving 0.5mg around 11am or noon and then at 4p or 5p. Another suggestion would be to change the Celexa to Lexapro 10mg qd-this antidepressant has benefit as an antianxiety med, also. Hope this helps, Mary
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