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Seroquel


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#1 Cheri

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Posted 04 January 2012 - 01:17 PM

My father has had PD for 18 years and has developed Dementia also (within the last 3 years). He takes Seroquel at night (100mg) which was given to help with hallucinations that he had been having at night, and also given to help him relax enough to sleep. With the development of dementia, is seroquel still safe for him to take - because according to information I read, it says not to. Also, it no longer helps him sleep through the night and this is causing tremendous hardship on my mother, his constant caretaker. Is there anything else that will help a PD patient sleep? And, can it be given with the Seroquel? Currently, my father takes Sinemet 3 times a day, and Numenda (spelling?) at noon.

#2 MComes RPH

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Posted 05 January 2012 - 10:37 AM

First thing I would like to say is, "Thank you," to you and your mom for being such great caregivers. I have always said it is tougher to take care of someone with PD than to actually have PD. Bless you both.
Ok, let's deal with the issues one at a time.
1- since he has PD and is now experiencing the dementia that can come with it, you may want to discuss with the Dr about replacing the Namenda with Exelon. Both are used for dementia but, the Exelon is specifically indicated for PD related dementia. It comes in capsules and also a patch form. The Exelon patch is very convenient and you just put on one patch on daily.
2- seroquel. I agree, if it does not appear to be working, look for an alternative. The Dr was using it it to take care of 2 issues, hallucinations and sleep aid. This is a tough situation because most medications used to treat hallucinations can make PD symptoms worse. Also, most sleep aids have the side effect of causing hallucinations. Here are my suggestions for you to speak with his Dr about:
For the hallucinations, a possible switch to Zyprexa or Risperadal may help. They are in a similar class as Seroquel, so just a switch within the class of medication may help. There is a medication call Clozipine that is used to treat hallucinations and does not worsen the PD symptoms. This is a medication that can affect white blood cells, so monthly blood work must be done. Like I said, I would talk to the Dr about the change to Zyprexa or Risperdal first and see what they think of the Clozapine.
3- the sleep issue. Another tricky situation, as I stated above. There is a medication called Rozerem which works like no other sleep aid available and has very little, if any, issue with hallucinations. Rozerem works by increasing the amount of melatonin the body produces. Melatonin is a natural substance that we all produce that helps us sleep. The older we get, the less we produce. So, this may be a good option for him. Another medication to help sleep issues is ambien. Like I said above, it can cause hallucinations, but at a low dose, the chances of it causing hallucinations is minimal and it does not cause the morning "spaced out" feeling most of these Meds do. Another option may be Restoril. It is an older sleep aid, but still very effective.
I think we covered it all. This is a very tricky situation but, I truly think that just the change from Nemenda to Exelon may help with the other issues he may be having.
Please keep me updated.



My father has had PD for 18 years and has developed Dementia also (within the last 3 years). He takes Seroquel at night (100mg) which was given to help with hallucinations that he had been having at night, and also given to help him relax enough to sleep. With the development of dementia, is seroquel still safe for him to take - because according to information I read, it says not to. Also, it no longer helps him sleep through the night and this is causing tremendous hardship on my mother, his constant caretaker. Is there anything else that will help a PD patient sleep? And, can it be given with the Seroquel? Currently, my father takes Sinemet 3 times a day, and Numenda (spelling?) at noon.


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 miracleseeker

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Posted 05 January 2012 - 01:22 PM

Sorry but I have to strongly disagree taking Risperdal for someone with PD. My mom's previous Neuro prescribed that to her a few years back and it made my mom's Parkinson worse. Risperdal is on a list of medications that SHOULD NOT be given to people with PD. At the time I was not informed enough to know what was happening and I called her doctor that Risperdal wasn't working. He told me to increase her dosage which caused a red flag in my mind and I didn't listen to him and instead I stopped it. Years later I found out it is not to be used for PD patients. Hopefully most Neurologists know this now. My mom was on Seroquel after that but it gave her nightmares so we just didn't bother trying something else. You pick your battles. Her hallucinations are not threatening to her and so one less drug is 15 less side effects to deal with that would entail more drugs to counter. This I know from personal experience from what my mom went through and further research on my part. Thank you.

#4 MComes RPH

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Posted 09 January 2012 - 10:41 AM

As I stated in The post that these medication can make the PD symptoms worse, refering to Zyprexa And Risperdal. I also stated that ther are very few options that will decrease hallucinations WITHOUT increasing PD symptoms.
I do appreciate your input, and we are all here to help eachother. As you noticed I gave several alternatives, options, And possible outcomes for each option available.
I do appreciate input and the issue that occured with your mother. I understand the issue at hand, but I must supply the "whole" story in order for the patient to discuss intelligently the options with the Dr. That is why I stated that this class can make the symptoms worse, and gave several other alternatives. Every person will react differently, And I know it is contraindocated. But, at a low dose, along with the change to Exelon, it may be a possibility. Also, just The change To Exelon may be the ticket itself.
Thanks For The input, I truly appreciate it. We are all here to help. By sharing our past experiences and background, we give knowledge to others.
Thank you again.

Sorry but I have to strongly disagree taking Risperdal for someone with PD. My mom's previous Neuro prescribed that to her a few years back and it made my mom's Parkinson worse. Risperdal is on a list of medications that SHOULD NOT be given to people with PD. At the time I was not informed enough to know what was happening and I called her doctor that Risperdal wasn't working. He told me to increase her dosage which caused a red flag in my mind and I didn't listen to him and instead I stopped it. Years later I found out it is not to be used for PD patients. Hopefully most Neurologists know this now. My mom was on Seroquel after that but it gave her nightmares so we just didn't bother trying something else. You pick your battles. Her hallucinations are not threatening to her and so one less drug is 15 less side effects to deal with that would entail more drugs to counter. This I know from personal experience from what my mom went through and further research on my part. Thank you.


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#5 miracleseeker

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Posted 09 January 2012 - 01:34 PM

Yes I saw your warning but... I'm the type of person who will not take risks. Risperdal is a big no-no on many many lists of drugs to not take for PD so had I know beforehand I would have never given it to my mom. I saw firsthand how badly she shook. Supposedly it interferes with the absorption of Levo/Carbo so I don't see anyone could be an exception but... hey never say never.

Caregiving is time consuming and exhausting but it's the patient with the limitations and pain and suffering. I always see care giving is a choice. You can walk away if you have the heart to do it but if you are the patient then you are stuck in a body that is failing you. No one wins here.

#6 MComes RPH

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Posted 13 January 2012 - 02:57 PM

Like I said, I understand your concern and really do appreciate your input. That is what this forum is all about, passing on personal experiences and stories to others, with the common goal of helping others.
We are all in this together. Stength in numbers, we stand side by side, hand in hand, never letting anyone break our chain or spirits. I would take everyone on this board into battle against anyone.
We have the fight, the fortitude, and, most of all we have the heart.
WE STAND UNITED.



Yes I saw your warning but... I'm the type of person who will not take risks. Risperdal is a big no-no on many many lists of drugs to not take for PD so had I know beforehand I would have never given it to my mom. I saw firsthand how badly she shook. Supposedly it interferes with the absorption of Levo/Carbo so I don't see anyone could be an exception but... hey never say never.

Caregiving is time consuming and exhausting but it's the patient with the limitations and pain and suffering. I always see care giving is a choice. You can walk away if you have the heart to do it but if you are the patient then you are stuck in a body that is failing you. No one wins here.


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#7 miracleseeker

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Posted 13 January 2012 - 07:33 PM

Bravo to you for being able to still work with this disease. I'm hoping someone will discover a natural food perhaps can actually cure it rather than more drugs.

#8 MComes RPH

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Posted 20 January 2012 - 12:37 PM

I will be honest, I would love to see that also. Unfortunately, much of our society runs off the "Eastern Medical Philosophy" istead of the "Western Medical Philosophy."
Here is a great example of the difference:

PATIENT HAS HIGH CHOLESTEROL:
Western Medical Philosophy: Stop eating fast food, red meat, and foods high in fat. Use a diet high in fish or lean chicken, vegetables, fruits, grains, and lots of water. You need to alter your lifestyle choices and exercise.
Eastern Medical Philosophy: Take this "statin" medication and do you best to eat better.

Well, I guess I would still have a job in western medicine, I would just be called "A Medicine Man" and not a "Pharmacist."


Bravo to you for being able to still work with this disease. I'm hoping someone will discover a natural food perhaps can actually cure it rather than more drugs.


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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