dosage of psych medication your person is on ?

livlea

Her medication per day; RISPERIDONE 0.5mg, CITALOPRAM 5mg, VENLAFAXINE 75 mg , blood thinner APIXABAN 5mg

She remains highly anxious and agitated , frequently crying and shaking. she is also very delusional and experienced another episode of delirium 2 days ago …during which she became combative with a nurse, . A few hours later,she had no memory of the incident…

Other times , she is calm,gentle and cooperative

Geripsych does not recommend increasing her antipsychotic (Risperidone) concerned it could disrupt her balance and increase the risk of falls.

I was curious about the dosage your person is on and how well it is tolerated in their case ?

livlea

harshedbuzz

@livlea

Prescribing psychoactive medications is something of a dark art rather than a science. What is effective and appropriate for one PWD may not be for another. Even in healthy individuals, response can be influenced by all manner of factors including genetics. It's great that you are working with a geripsych as they are the specialists in this area of medicine.

Are these long-standing medications for your LO? Were they ever adequate for her agitation? Or is she new any of them? The SSRIs can take up to 6 weeks before your might see the benefit to her. She is taking very low doses of both citalopram (typical starting dose is 20mg/maintenance is 20-40mg) and venlafaxine (75mg is a starting dose/75-225mg is maintenance for moderate depression). It might be she needs a higher dose of one or both of these meds or, if these have never been effective for her, another formulation of SSRI like Zoloft or Lexapro.

Her risperidone dose is pretty typical. Like the SSRIs, it can take a month or so to know what you can expect from the antipsychotic. In the context of the blood thinner, the fall risk is an important consideration. The threshold for falls drops as the disease progresses even without a medication side effect in play. The starting dose here would be 25mg or even 12.5mg. Is she taking the medication 25mg morning and evening or all at once? Response to atypical antipsychotics can be just as individual as to SSRIs. She might do better on something else— Seroquel, for instance.

In addition to medication, it's important to make sure the people caring for her are using dementia-informed strategies in interacting with her. You mention a nurse— is she hospitalized (if so, all bets may be off until she's discharged and back to her routine)? Or is she in a facility or at home? Are the people caring for her well trained and using techniques like validation?

While a certain amount of agitation is not uncommon in trying to balance quality of life, side effects and sedation, you certainly don't want her miserable either. My dad had a tendency to showtime for people. The man put on some Oscar-worthy performances for his geripsych which meant getting him appropriately medicated was a challenge. I'm certain his doctor thought I wanted him knocked out until I sent him a video clip of one of dad's typical meltdowns. It got him an additional 25mg of Seroquel which was enough to make it possible for him to stay home with my mom as long as he did.

HTH-
HB

livlea

Risperidone started August 2023 @ a minimal dose of 0.25 mg and increased to 0.5 mg in December 2023 ( not 5 mg but 0.5mg)

Pretty sure it could be increased, tha’s why I was asking this board about your LO’s dosage

She just moved 2 weeks ago from Psych hospital to AL in a secured unit 12 people, all her symptoms came back , anxiety, delusions ,delirium, hopefully Dr. could see her soon