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What causes agitation and inappropriate sexual behavior while having dementia?

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Posted on Fri, 13 Jan 2017
Question: My father is 87 and suddenly has dementia/combative behavior. He began taking ativan 3 days ago. pills are 1 mg and are taken for a total of 2mg in 24 hours. He is sleeping ok but masturbation and inappropriate comments toward his female caregivers is occurring. What to do?

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Answered by Dr. Olsi Taka (20 minutes later)
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.

Agitation and inappropriate behavior are a common problem with dementia. I am not sure Ativan is the appropriate choice for that, in old age it is often not effective and increases confusion.

Of course, there is no perfect drug for it, all medications acting on central nervous system have potential for side effects. However to control those symptoms the most effective medication are antipsychotics, I would use Quetiapine, starting with the lowest dosage of 12.5 mg and if not enough may be slowly increased.

I remain at your disposal for other questions.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Olsi Taka (34 minutes later)
we do have .25mg xanax available, we are concerned about his caregivers and would like to stop the ativan side effects. Would a small dose of xanax be appropriate?
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
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Detailed Answer:
Xanax (Alprazolam) is in the same group as Ativan (Lorazepam), both benzodiazepines, so does not offer any significant benefit compared to Ativan I am afraid.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (34 minutes later)
My father was seen by a neurologist twice while he was admitted for 12 days @ XXXXXXX Hospital, he was discharged a week ago today. While in the hospital they had to give him ativan several times because of his combativeness. Upon discharge we were not given any prescriptions to aid us. Do you know if it is possible to contact a neurologist that had seen my father during his most recent visit and see if they could provide a prescription for Quetiapine? It's almost impossible to get an appt at this time. Any suggestions on how to proceed would be greatly appreciated. Thanks again
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Answered by Dr. Olsi Taka (14 minutes later)
Brief Answer:
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Detailed Answer:
As I said before while I understand the neurologists there thinking that Ativan is perhaps safer for short term use, I do not think it to be the most effective for agitation and psychosis in dementia. I am afraid though that it is hard for me to suggest how to be able to reach the neurologist at XXXXXXX With me exercising in Europe we have completely different health system organization.

I would suggest you contact your primary physician instead. He can prescribe Quetiapine instead of the neurologist. Perhaps he can contact the neurologist through the contact details in the discharge papers (although again I am not sure how the system is organized there).

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3668 Questions

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What causes agitation and inappropriate sexual behavior while having dementia?

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. Agitation and inappropriate behavior are a common problem with dementia. I am not sure Ativan is the appropriate choice for that, in old age it is often not effective and increases confusion. Of course, there is no perfect drug for it, all medications acting on central nervous system have potential for side effects. However to control those symptoms the most effective medication are antipsychotics, I would use Quetiapine, starting with the lowest dosage of 12.5 mg and if not enough may be slowly increased. I remain at your disposal for other questions. Regards