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Benzodiazapines made mom wander off bat-butt crazy. The Seroquel was at 25mg for one month and has been at 50mg for three months and no calming effect. She was scared at her house, scared at my sister's house, and now calling me constantly from her assisted living apartment scared of everything and everyone there. She cries cries cries. She's been on 225mg effexor for 20 years.
I realize paranoia and fear are a symptom of various dementias, but my goodness, this seems so over the top. Have you ever known talk therapy to help a dementia patient? I listen and reassure and redirect until I'm blue in the face. My mother is suspicious of her psychologist, suspicious of nurses. She thinks they all hate her no matter how kind and soothing they are to her. How high can a senior go on Seroquel and would it even matter? Do you suppose she'll just die of terror some day?

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As your Mom was already on Effexor for two decades it seems to me that you are dealing with someone whose chronic problems are now greatly exacerbated by dementia. I am so sorry. As to dying of terror, that is more unusual in cases of chronic anxiety than it is in cases of sudden traumatic terror, but as to what this chronic distress does to the body in terms of blood pressure, cortisol levels and etc. is difficult to measure in studies.
I am so sorry. In the case of psychological problem and esp with chronic anxiety of and depression with complications of dementia it is often a matter of a good neuro-psyc doctor who tries varying dosages and varying drug combinations to bring relief. The problem is that with these drugs one must wait one to two weeks to know effect, and even when a good effect is found the patient often isn't helped over time and a working combo suddenly IS NOT working. It makes it terribly difficult, and often in nursing homes we see patients that are overly medicated into near stupor in order just to be able to deal with the day to day.
This is such a difficult situation for both patient and family. I couldn't be more sorry you are dealing with it, and other than good professional help I can't imagine how to guide you. I sure wish the best for you and for your Mom.
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NeedHelpWithMom Apr 2021
Alva,

I know someone so riddled with anxiety that she says, “I am afraid to live but afraid to die.”

Severe anxiety is the worst. I suppose severe depression too.

Anyone can get through temporary situations. When it’s chronic it has to be almost unbearable.
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Talk therapy usually does not help those with dementia. Consistent routine and patience go hand in hand with anti-anxiety medication. Psychoactive medications take time to be effective - to build up in the blood stream to therapeutic levels. It also takes time to find the right combination of medications to help each person. Keep working with the doctor.
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I would start with a neuropsychological consult. Bring a list of all current meds. My mother had undiagnosed mental health issues her entire life. AZ made her mild paranoia much worse. And her aggression. Then she was put on mementin AZ drug and she stopped eating because she thought someone was poisoning her food. After a trip to the hospital psych ward I insisted she be taken off of that drug. She was put on Augmentin instead and huge improvement. So be a forceful advocate you have to push. Everyone told me that drug was fine but it wasn’t fine for her.

mom still has bouts of anger and paranoia and they have increased seroquel to twice a day. Sometimes you have to experiment until you find what works. If nothing works you know you did your best and it’s just a sad reality. Hope you both can get some relief.
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I am sorry you have to go through this. It is exhausting. My father is in mid/late stages of Alzheimer’s and becomes fearful in the evenings (sundowners symptoms). He is afraid his house will burn down (he lives with me now). Sometimes when I return home from work or running errands, I discover that he had unplugged everything and taken apart my light fixtures. His doctor put him on Olanzapine (5mg) for the morning and 100mg of Trazadone at night. This helps a little ......but...I also learned that Melatonin will help ‘ease him out’ a little too. I asked his doctor if it was safe and the doctor said ‘yes.’ So I give him 10 mg of that in the evenings as well. I noticed a difference with the Melatonin. Hopefully you can find some relief for her. Seeing my dad so vulnerable breaks my heart and I will do anything to help try to reassure him or bring him comfort/peace. I wish you well.
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I find that no amount of talking helps my mother with dementia, she's back on the same topic almost immediately after I 'talk her off the ledge'...........like 2 minutes later, literally. But she's at the moderately ADVANCED stage of dementia. So I'm questioning your mother being at the 'early stage' as you say. Plus, the Seroquel is not working if it's having no calming effect, so it's time for another chat with the doctor. Or, it may be time for a new doctor or a geriatric psychiatrist to meet with her for a consult. It's not right for a person to be THIS terrified all the time, like cxmoody's mom and your mom are.

Taking calls from her all day long and NOT being able to calm her down aren't helping either of you, either. You may want to decide how many calls per day you'll take from your mother, have a pat list of 'calming' suggestions for her, and leave it at that. I speak to my mother once a day at her Memory Care, and she asks me where her papa is, and lets me know she's getting dressed to take the bus to Brooklyn (3500 miles away) to see him. He's been gone since she was 16 years old. There's really no getting her to understand otherwise, either, but at least she's not frightened or too terribly distraught over things in general, thank God.

I'm sorry you have to go through this, and that your mom has to go through this too. I'd be talking to her doctor again to see what ideas s/he has for helping her out.

Best of luck!
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NeedHelpWithMom Apr 2021
That’s super stressful for all of you!
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In agreement here for a complete and urgent medication review.

Finally, venlafaxine (Effexor) could possibly cause an increase in serotonin leading to a condition called serotonin syndrome. It is vital to inform a doctor about all medications being taken at the time of prescription. Serotonin syndrome can be recognized from the following symptoms:
Fast or irregular heartbeat
Hallucinations
Loss of coordination
Severe dizziness
Severe nausea/vomiting/diarrhea
Twitching muscles
Unexplained fever
Unusual agitation or restlessness

My thinking is the addition of other meds could have led to Seratonin Syndrome.
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Last week I requested a prescription review. Seroquel made my mom crazy. She was at 25 and last week was dropped to 12.5. The difference is unbelievable.
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Imho, dementia most likely has exacerbated your mother's anxiety and the medication that she took for two decades may no longer be effective.
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Seroquel is an anti psychotic.

Xanax or Valium are benzodiazepines.

Kind of have similar qualities, but work differently in the brain.

No, it's not OK for someone to be terrified all the time. Mom needs to see a geripsych doc. The Seroquel will make her sleepy, but then she's sleepy AND terrified.

Benzos will calm her and then maybe some talk therapy (you doing it) will be able to take the edge off her anxiety. Poor thing.
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NeedHelpWithMom Apr 2021
True, my mom was waking up and trying to walk out of my brother’s front door in the middle of the night.

My brother even barricaded the area with chairs and she pushed her walker through it all! Scary!

That’s when she was put on Seroquel.

When she entered a hospice house they left her on it. She’s completely bed bound now.
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²0 yrs. On efflexor seems toe to be too long. And her body is no longer responding. Any meds that she has been on for many years change to something else.
I used to be on efflexor, paxil,sinnequin, and many others they all worked but only a short time. Our bodies get used to the meds then it is time to try something else.
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