Depakote Extended Release (ER) Versus Seroquel for Agitated Behaviors in Nursing Home Care Unit Patients With Dementia

Inclusion Criteria: Veterans Males or females Aged 55 or older With a diagnosis of dementia (either Alzheimer's disease, vascular dementia, or mixed Alzheimer's and vascular dementia) Residing in a Tuscaloosa VA Medical Center (TVAMC) NHCU bed Admitted to a NHCU bed at Tuscaloosa VA Medical Center Score of > 5 on the Functional Assessment Staging (FAST) scale Score of < 23 on the Mini-Mental State Examination Score of > 1 on the Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) global rating Total BEHAVE-AD score of > 8 Agitation present (by history or chart review) for at least two weeks (to minimize chance of enrolling for agitation due to delirium). Exclusion Criteria: Diagnosis of dementia caused by a condition other than either Alzheimer's disease, vascular dementia, or mixed Alzheimer's and vascular dementia History of schizophrenia, bipolar disorder, or schizoaffective disorder Untreated depressive or anxiety disorder Untreated pain evident on physical examination Known allergy or hypersensitivity to either study drug History of epilepsy or seizures Diagnosis of liver disease or significant abnormalities on liver function tests Thrombocytopenia Diagnosis or past history of pancreatitis Past history of neuroleptic malignant syndrome Co-morbid condition that would render tapering off of current antipsychotics or anticonvulsants unsafe History of agitation unresponsive to an adequate previous trial of either valproate or quetiapine The patient has no identifiable guardian, decision-making proxy, or next of kin to approach for consent to participate. The patient's guardian, decision-making proxy, or next of kin withholds, or does not grant, consent to participate Patient judged to be too ill to participate