5 Best Medications for Sundowning: Effective Sundowners Treatment

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Creator: Liv Hospital
Published: 2026-01-01

Struggling with sundowning in dementia? Our guide covers the 5 best meds for sundowners to effectively manage symptoms.

Aslı Köse

Valdori Content Team

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5 Best Medications for Sundowning: Effective Sundowners Treatment 4

Sundowning is a complex condition that affects many with dementia, including Alzheimer’s disease. As the sun sets, those with sundowning may show more confusion, agitation, and changes in behavior. Studies suggest that sundowning impacts up to two-thirds of Alzheimer’s patients and others with dementia.

It’s important to understand the causes and symptoms of sundowning to manage it well. At Liv Hospital, we focus on each patient’s needs with care that’s backed by science. Our approach combines the newest treatments and therapies to enhance life quality for sundowning patients.

Key Takeaways

Effective management of sundowning requires understanding its causes and symptoms.
Sundowning affects up to two-thirds of people with Alzheimer’s disease and other dementias.
Patient-centered care is key to improving life quality for those affected.
Liv Hospital offers detailed, tailored treatment options.
The best medications for sundowning are part of a full treatment plan.

Understanding Sundowning and When Medication Is Necessary

image 4408 LIV Hospital — 5 Best Medications for Sundowning: Effective Sundowners Treatment 5

It’s important to know about sundowning and what causes it. Sundowning happens in the late afternoon and evening. It includes symptoms like confusion, agitation, and trouble sleeping.

Things like new places, dim lights, and tiredness can make sundowning worse. Knowing what triggers it helps in managing it better.

Before thinking about medicine, try non-medical ways first. A regular routine and a calm place can help a lot. For example, better lights and less noise can make people feel more relaxed.

But sometimes, medicine is needed for severe sundowning. If other methods don’t work, doctors might suggest medication. This can help with agitation and other tough behaviors.

Trigger	Description	Management Strategy
Unfamiliar Surroundings	New or changing environments can cause confusion.	Gradual introduction to new environments, maintaining familiar objects.
Low Lighting	Inadequate lighting can exacerbate confusion and agitation.	Improving lighting, specially in the evening.
Fatigue and Pain	Physical discomfort can trigger sundowning symptoms.	Ensuring adequate rest, managing pain effectively.

Understanding sundowning and using both non-medical and medical ways can help a lot. Caregivers can offer better support this way.

5 Best Meds for Sundowners: A Guide to Treatment Options

image 4409 LIV Hospital — 5 Best Medications for Sundowning: Effective Sundowners Treatment 6

For those with sundowning, a condition causing agitation and confusion in the late afternoon, medication is key. Sundowning often goes hand in hand with dementia and Alzheimer’s. Finding the right treatment is vital for bettering their lives.

We’ll look at the top meds for sundowning. We’ll cover how they work, their side effects, and how well they work. Choosing the right medicine is important. It depends on the person’s needs and health history.

1. Brexpiprazole (Rexulti)

Brexpiprazole, known as Rexulti, is approved for sundowning in Alzheimer’s patients. It affects brain chemicals like serotonin and dopamine. These help control mood and behavior.

Key Benefits: It helps reduce agitation, a common sundowning symptom.

Potential Side Effects: It can cause restlessness, dizziness, and may increase stroke risk.

2. Risperidone

Risperidone is used off-label for sundowning. It’s effective against aggression, agitation, and psychosis in dementia patients.

Key Benefits: It manages aggression and agitation well.

Potential Side Effects: It may increase stroke risk, cause extrapyramidal symptoms, and make you feel sedated.

3. Quetiapine (Seroquel)

Quetiapine, or Seroquel, is used for sundowning. It has sedative effects, which can help with nighttime agitation.

Key Benefits: Its sedative effects can improve sleep issues linked to sundowning.

Potential Side Effects: It can make you drowsy, cause dry mouth, and may lead to weight gain.

4. Trazodone

Trazodone is sometimes used for sundowning, mainly for its sedative effects. It’s considered when antipsychotics are not suitable.

Key Benefits: It has sedative effects without the risks of antipsychotics.

Potential Side Effects: It can cause drowsiness, dizziness, and in rare cases, priapism.

Medication	Primary Use	Key Benefits	Potential Side Effects
Brexpiprazole (Rexulti)	Agitation in Alzheimer’s	Reduces agitation	Restlessness, dizziness
Risperidone	Aggression, agitation	Manages aggression	Increased stroke risk, EPS
Quetiapine (Seroquel)	Sundowning symptoms	Sedative effects	Drowsiness, dry mouth
Trazodone	Sundowning symptoms	Sedative effects	Drowsiness, dizziness

Conclusion

Managing sundowning syndrome in the elderly needs a full plan. This plan should include non-medication steps and, if needed, medication. There’s no one-size-fits-all medicine for sundowners, as each person’s needs are different.

Creating a treatment plan for sundowning involves teamwork. Caregivers and doctors work together to make a plan that fits each person. This plan might include certain medicines and other support to help those with sundowning.

Learning about sundown syndrome and its treatments is key. This includes looking into sundown syndrome medication. A mix of treatments is important to meet the complex needs of those with sundowning.

The main aim is to make life better for those with sundown syndrome. Using medicine and supportive care together can help. This way, we can support both the individuals and their caregivers.