Quetapine sp? Has been suggested for my gran if she struggles with movement and hallucinations in place of levodopa.
I've heard horror stories about it being an antipsychotics but I thought you couldn't have that sort of medication for lbd patients?
This is from a movement specialist.
Rivastigmine is another possibility for a treatment option.
They tried quetiapine alongside levadopa for my husband, but it made him worse. A very small dose of haloperidol kept him reasonably happy until he had been weaned off mirapexin and could start taking galantamine (an alternative to rivastigmine for dementia symptoms). He now takes a homeopathic remedy to help with nightmares and hallucinations. Everybody is different and if one drug doesn't suit there is usually something else to try.
Thanks for your response weirdly gran seems OK at the moment. She's just very exhausted. Hoping to get a new Dr soon as grans leaves.
My mother with Alzheimer's was out on that and developed permanent side effects, including tardive dyskenesia, that eventually sped up her death. While it was a relief to have her out of suffering I wouldn't have her take it again.
Antipsychotic agents are designed to balance abnormal chemical levels in the brain.
They work by reducing excess dopamine thereby, alleviating psychosis. Up until the 1990’s, the use of antipsychotics in PD had been controversial. This was because older, also known as “typical”, antipsychotic medications were found to cause dramatic worsening of Parkinsonian motor symptoms.
Fortunately, newer medications have become available that are better tolerated by PD patients. This newer class of medications is referred to as “atypical” antipsychotics.
There are two “atypical” antipsychotic medications that are considered safe for PD patients. They cause limited worsening of Parkinsonian symptoms while treating psychosis. These medications are clozapine (Clozaril ®) and quetiapine (Seroquel ®).
From the Parkinson foundation web site.
Thanks for your responses. As antipsychotics reduce dopamine levels in the brain causing parkinsonism giving antipsychotics to pd patients makes no sense.
Yes that is why I printed that info above. These meds are not something we can play around with.
It is always a challenge to work out the cause of hallucinations - disease progression, medication, infection or a combination.
I've.had a few replies on here and a few patients have reacted to quetapine despite it being recommended on the pd website.
The hallucinations appear to have increased and i seem to be the only person who can talk her round as i attempt to interact with them best i can. ive had to pretend to be grans hubby (whose dead), sister, uncle, brother, my brother, my mum all in the space of a few hours to keep her calm. My logic is if grans calm she will eat and drink.
The other day gran was determined to eat the pink sequin item in her hand............. her closed purse. She had a purse in between whats left of her teeth and was gripping it tightly. i had to get it out of her hand to hide her purse as she could have swallowed the clasp. Why would gran try and eat a sequined purse? UTI?
A few days later and i hear grans better and has been less violent and resistant to going to bed. She never was violent pre dementia.
PD botcamp
General Anaesthetic and PD
Good neurologist for PD
Does alcohol makes PD more aggressive and I shouldn’t drink anything at all. 
