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I have a friend from church, who is caring for his wife and she is seeing people and gets very fearful ,as it gets later in the afternoon.

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Hi Carol! I was having some problems with my mom's sundowner's that seemed to be getting worse, especially after 6:30 P.M. but sometimes as early as 3:30. She started the "I want to go home" and occasionally would try to leave. Then when the caregiver started coming later she became more and more agitated and combative even, so the caregiver suggested that I call the doctor and see if they could prescribe a medication to calm her down as the symptoms were becoming more and more unmanageable and every night was like a battle zone! The doctor prescribed Lorazepam which is the same thing as Ativan. She has taken it for the past 2 nights. Since then she has been much more pleasant to be around and we have had no issues with her becoming scared, agitated, combative, or wanting to leave. Best of luck to you and I hope this helps!
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My husband, age 84, was having sundowning. The Doc discontinued his Aricept, Ativan and Wellbutrin and added Namenda, Seroquel and Zoloft. He takes Namenda, Zoloft and 1 Seroquel (25mg) in AM and 1 Seroquel around 5:00pm. This really helps the sundowning. He also takes 100mg at night to sleep. I think it is like others are saying; everyone is different so what works for one may not work for another.
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My sister wasn't sun downing, but she had delusions that everyone (neighbors, the dentist, me, etc) was stealing from her. She obsessed about the imagined stealing day and night, and was always scowling and accusing A tiny dose of risperidol has removed her paranoia, and she is much much happier and more relaxed. She smiles and is pleasant all the time now. No apparent side effects. I wish I had known about this when my mother went through a paranoid period.
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My mom takes namenda and it works well. Plus other stuff I am not sure what. Also, ativan for anxiety, she has a lot of that. When she had audio hallucinations she was taking clonopin and risperdol. both worked fairly well but didn't calm her down enough for long.
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My mother-in-law developed Sundowners from her sleeping pills. The doctor prescribed another medication and the problem was solved. Your friend is lucky to have you for a buddy!
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I have to say, my husband came home from a hospital stay w/scrips for Namenda and Seroquel. He had classic sundowners until we dc'd the seroquel. He did well on Namenda and Arosept.
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My mother gets sundowners and they gave her risperdol and some other meds, but everything seemed to agitate her so we took her off those meds as the doctor said at her age they were not good for her any way, we now use Sunny Day, its a natural and it seems to calm her
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Sometimes mood stabilizers are helpful. Sundowning often culminates in violent behaviors in the afternoon or evening. Depakote is an anti seizure medication that is frequently used for mood stabilization with few side effects. Risperdol is another good one as mentioned above. I have also seen Seroquel used if there is are symptoms of psychosis. I have seen Xanax used for intense anxiety for distressing delusions which has a longer time of therapeutic effect than Ativan. You will have more success with this type of problem from a Psychiatrist with Geriatric experience than from your Primary Care Physician.
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My Dad is on Depakot, along with Namenda, & Aracept. The Depakot is for bi-polar and seems to even out his moods. He still gets some anxiety late in the day, but otherwise, he doesn't get overly angry anymore. I am so thankful for that!
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They changed my mother in law to Namenda XR because insurance would not cover the Namenda twice a day. Hallucinations started after the first day. They got worse as the days went on. We stopped the Namenda XR and the sundowners has not reappeared. She is more interactive. We just brought her out of assisted living to our home so I am not sure if the regular Namenda caused the same problems since we were not around 24-7. She is less disoriented now. The dementia is getting worse but we no longer are up and down all night.
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