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Alzheimer's Disease

Severe Audio, Visual Hallucinations, Paranoia



My father has dementia with severe auditory & visual hallucinations and paranoia. He has sundowner`s symptoms also. During the day, he is manageable by caregivers but at night, around 1:00 am, he is wide awake, seeing and talking to people that aren`t there, hiding in closets, and trying to get other residents to safety. He also gets combative. Is there a medication that will help with the hallucinations?


I am unable to give specific advice without knowing more information. However, there may be several possible approaches. If most of the behavioral disturbances occur just at night, your father's physician might consider a medication like trazodone which helps with sleep and he may sleep through these behaviors. If the behaviors are part of a sleep disturbance; that is occurring while he is dreaming (REM sleep behavior syndrome), than clonazepam in very low doses may be appropriate. If he is not sleeping when these behaviors are occurring and trazodone is not helpful, than an antipsychotic medication may be appropriate such as quetiapine or ziprasidone. Many times medications can be helpful. They all can have side effects which need to be discussed carefully with his physician before starting.

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Response by:

Douglas W Scharre, MD Douglas W Scharre, MD
Clinical Associate Professor of Neurology
Clinical Associate Professor of Psychiatry
College of Medicine
The Ohio State University