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Suggest Treatment For Aggressive Behaviour In A Dementia Patient
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
It is true that antipsychotic drugs have the potential for too much sedation among other side effects. They are not preferred unless the patients is showing psychotic symptoms (hallucinations, delusions) or aggression.
However they remain the only really effective means for such symptoms. It is important when considering the other times they have been used to consider the dosage. It is always started at the lowest possible dose and increased gradually only if that dose is not effective. That way it should be possible to gradually find the right balance to calm the patient without putting him into deep sleep.
I usually use Quetiapine, in a patient of that age would start with half of a 25 mg tablet, increasing it gradually only if that doesn't work.
As for that combo you have been suggested I think it's too much, especially if you mean to start them all at the same time. Zyprexa is also an antipsychotic, so what was said for starting small and raising the dose applies to it as well.
Remeron is an antidepressive, used mostly for depression in such patients, though it also causes sedation. Depakote is a mood stabilizer which may be considered at times, but again would start with an antipsychotic. As for Attivan I do not recommended, it is used often in aggressive patients, but in the elderly it is often not as effective, only augmenting confusion. In addition it is not a medication which is recommended to be used regularly as regular use causes dependence and tolerance.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
It is true that antipsychotic drugs have the potential for too much sedation among other side effects. They are not preferred unless the patients is showing psychotic symptoms (hallucinations, delusions) or aggression.
However they remain the only really effective means for such symptoms. It is important when considering the other times they have been used to consider the dosage. It is always started at the lowest possible dose and increased gradually only if that dose is not effective. That way it should be possible to gradually find the right balance to calm the patient without putting him into deep sleep.
I usually use Quetiapine, in a patient of that age would start with half of a 25 mg tablet, increasing it gradually only if that doesn't work.
As for that combo you have been suggested I think it's too much, especially if you mean to start them all at the same time. Zyprexa is also an antipsychotic, so what was said for starting small and raising the dose applies to it as well.
Remeron is an antidepressive, used mostly for depression in such patients, though it also causes sedation. Depakote is a mood stabilizer which may be considered at times, but again would start with an antipsychotic. As for Attivan I do not recommended, it is used often in aggressive patients, but in the elderly it is often not as effective, only augmenting confusion. In addition it is not a medication which is recommended to be used regularly as regular use causes dependence and tolerance.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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