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Suggest Treatment For Vascular Dementia

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Posted on Mon, 27 Apr 2015
Question: Approx. 68yo overweight woman with long hx back injury 2nd auto accident as a teen now has signs of progressive decrease in memory with irritability and agitation, fearfulness, spatial disorientation, and has been told may have incr. CSF pressure. She and her husband leery of an LP. She is showing slowly progressive impairment in marital trust with mild but lingering arguements. Recently couple told she should take Risperidone. I'm a retired psychiatrist and friend of the their family; I'm less sure. What about Celexa, for eg? Or any other recommendation(s)? Thank you so very much.

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Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
seroquel or zoloft are better options

Detailed Answer:
Hello Sir,

Thanks for writing to us.

She has likely vascular dementia with psychotic features.We need to evaluate the reason for marital trust.For irritability,agitation,fearfulness risperidone can be used but Seroquel(Quetiapine) is better option according to me. It causes more sedation and also used in bipolar disorder with advantage of controlling anger.
Seroquel has slight advantage over other antipsychotic like risperidone that it is associated with low death risk.
If at all depressive features are there Sertraline(Zoloft) is better than celexa.
Zoloft is more useful in patient with cerebral vascular problem as well as it has good tolerability than celexa.

Either of seroquel or zoloft or both can be used depending upon history,examination and diagnosis.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Treatment For Vascular Dementia

Brief Answer: seroquel or zoloft are better options Detailed Answer: Hello Sir, Thanks for writing to us. She has likely vascular dementia with psychotic features.We need to evaluate the reason for marital trust.For irritability,agitation,fearfulness risperidone can be used but Seroquel(Quetiapine) is better option according to me. It causes more sedation and also used in bipolar disorder with advantage of controlling anger. Seroquel has slight advantage over other antipsychotic like risperidone that it is associated with low death risk. If at all depressive features are there Sertraline(Zoloft) is better than celexa. Zoloft is more useful in patient with cerebral vascular problem as well as it has good tolerability than celexa. Either of seroquel or zoloft or both can be used depending upon history,examination and diagnosis. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.