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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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My mother is 98 and has age-related dementia. She's in a

Customer Question

My mother is 98 and has age-related dementia. She’s in a skilled nursing facility. The psychiatrist wants to start her on Risperidone. It would replace her ativan gel, which is prd. She has anxiety and repetitive delusional thinking leading to lashing out physically with helpers. I read that Risperidone is not recommended for elderly patients with dementia. What do you think? Are there other anti-psychotic alternatives?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. Risperidone and all of the atypical antipsychotic medications carry a risk of increased death due to cardiovascular issues with the elderly, so I understand your concern. But if the dose is considered low to moderate, no higher than 2mg per day would be preferred. Risperidone is considered the best to lessen aggression, which is why it is a first line treatment in conditions similar to your mothers. So no matter what antipsychotic medication her doctor suggests, the increased risk of death is still present, but this can be significantly minimized if she is taking a low dose of said medication. So if Risperidone is recommended, ask her doctor to start her off on a low dose like .5mg or 1mg/day to see how your mother reacts and then go from there. If she does not respond to Risperidone than Olanzapine should be considered next as that has good treatment results. Here is a good article on the use of atypical antipsychotics for the elderly.

I hope this helps and please if you have any follow up questions feel free to ask.