What is your approach to addressing dementia-related agitation for patients living at home with family?
Answer from: at Community Practice
There is absolutely no simple way to answer that question. Even when the family is providing a very calm and nonconfrontational environment, avoiding any possible way of causing the agitation, it is virtually impossible to predict when and why a person with dementia would become agitated, angry, unp...
Comments
at UNC Health
Environmental and behavi...
at Thapar Renu K Office Routine and caregiver changes cause a lot of distu...
at Christianacare Wilmington Hospital
Aside from non-pharmacol...
I would recommend first deciding if the agitation is emergent, urgent, or non-urgent. My definition for these three situations is: Emergent means if nothing is done, the patient will need to be hospitalized within the day. Urgent usually means you might have a bit less than 1 week to make a change b...
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at Centre For Behavioral Health I agree with the above. I would also consider usin...
at Private Pratice In patients who have become significantly aggressi...
at Steven A. Fayer MD PC I agree fully. I often use low-dose Olanzapine for...
at Psychiatric Group Of Princeton I read the article that Dr. @Chen referenced. It m...
at Kaiser Permanente
Lorazepam is useful for ...
I have been providing ho...
at Thapar Renu K Office Keeping basic safety principles in mind, work with...
Rexulti (Brexipiprazole), is FDA-approved for agitation in dementia, there is some evidence that SSRI like Lexapro can work but obviously will take longer. Trazodone can make blood pressure worse in the elderly, so I tend to stay away from it. Studies are ongoing about low-...
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at Thapar Renu K Office Lithium is difficult to manage in medically ill el...
at South Broward Hospital District Yes, but if living at home with family, they can h...
at Next Step 2 Mental Health Lithium is not difficult to manage in the medicall...
We’ve got to use more low-dose lithium for these patients. It’s a natural and very well-tolerated substance with a lot of evidence in reducing impulsivity and agitation, including independent evidence of a prophylactic effect against worsening of cognitive decline. Unfortunately, too man...
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at Independent Psychiatric Consultants Interesting, but any literature?
at Walter Reed National Military Medical Center This does sound interesting. There was a randomize...
at Next Step 2 Mental Health Here's a smattering of papers on the topic. There ...
The American Geropsych recommended a small dose of trazodone as a first-line agent to manage agitation in dementia due to the lack of black box warnings in patients with dementia. Antipsychotics would be the next line of treatment and is the most commonly used class of medication for managing agitat...
Comments
at Thapar Renu K Office Counting on simple meds like Trazadone if they wor...
Brexipiprazole ....I know it is expensive, possibly no different than aripiprazole, etc., but it is FDA-approved. Otherwise agree with trazodone, low dose of lithium is interesting, so long as we aren't worried about UTIs, etc, I tend to add an SSRI initially to see if it has any benefit.Lee et...
Comments
at Thapar Renu K Office Know your patient and do what it takes to relieve ...
at Steven A. Fayer MD PC My go-to med is Olanzapine 2.5 mg. PRN.
Environmental and behavi...
Routine and caregiver changes cause a lot of distu...
Aside from non-pharmacol...