QuestionMy 86 year old grandmother had 2 extreme emotional outbursts (crying, yelling, lack of sleep) in the past year and had to be hospitalized. As far as I know, she has not been diagnosed with Alzheimer's or dementia. She has been tested and no stroke, blood clot or infection was found. She also has high blood pressure and congestive heart failure. We also have lost 5 members of the family in the past year and a half. The hospital staff changed her heart medication (diltiazem & lasix) and gave her Seroquel at night to calm her and help with sleep. She was given 1/2 of a 25mg tablet, and has been taking this every night for 5 months. She has not had any more outbursts, but has developed increased mouth movements (TD-like symptoms: biting jaw, rubbing tongue over teeth, licking lips, etc), and her cataracts have become worse. I decreased her dose to 1/4 of the 25mg tablet for the past 2 weeks, and the mouth movements and worsened vision are still bothersome. I have also noticed increased irritability and she doesn't sleep as long in the mornings. Should she discontinue the quetiapine? One doctor wants her to stay on it indefinitely, and the other said she could stop, but I am concerned about insomnia and withdrawal problems. Any help is appreciated, thanks.
AnswerI can't make a call as to whether she should take these meds or not, but I can see the issues.....
She isn't demented, but is clearly distressed, probably some depression, seeing family die around her and feeling her own time may be coming. Does she have comtemporary friends she can talk to, people her age? Often when you get older, you lose a lot of your friends and become somewhat isolated.... your kids and grandkids are there but those relationships are a little different.
Seroquel could be responsible to the TD symptoms.... it isn't a bad drug to sleep with.. you don't build up tolerance, it works pretty well. There are other medicines to try, but overall, this isn't working too badly. There is not withdrawal like with other sleeping pills......
