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Suffered Heart Attack. Have Dementia. Frequent Strokes. Hallucination And Violent Behavior. Anti Psychotic Medication?
My father is 83-year-old and has a long history of various ailments, including dementia. He had suffered a massive heart attack when he was 39 year. He was doing fine with medication but in last seven years he had many strokes damaging his brain. Of late he has become very violent and also hallucinate a lot. He was taking Zapiz earlier to control his anxiety. Please advise which is the best antipsychotic drug for him.
Mon, 6 May 2013
Hi,
Based on your history , it seems that your father had previous heart attack (CAD) , followed by repeated brain stroke ( CVA ), which have led to multi infarct dementia in your father which is producing all these psychotic symptoms. Another reason of psychosis (hallucination) can be due to involvement of certain lobes of brain (temporal , frontal lobe), it can be also a seizure phenomenon( autonomic seizures)if symptoms are episodic .Consult neurologist and psychiatrist for evalaution and management.
Being a cardiac patient antipsychotic of choice in his case is Qutiapine to start 25mg twice daily then titrate to maximum dose
Regards
Dr Sandhya Manorenj
Neurophysician
Hi tech city , Hyderabad
Based on your history , it seems that your father had previous heart attack (CAD) , followed by repeated brain stroke ( CVA ), which have led to multi infarct dementia in your father which is producing all these psychotic symptoms. Another reason of psychosis (hallucination) can be due to involvement of certain lobes of brain (temporal , frontal lobe), it can be also a seizure phenomenon( autonomic seizures)if symptoms are episodic .Consult neurologist and psychiatrist for evalaution and management.
Being a cardiac patient antipsychotic of choice in his case is Qutiapine to start 25mg twice daily then titrate to maximum dose
Regards
Dr Sandhya Manorenj
Neurophysician
Hi tech city , Hyderabad
I find this answer helpful
hello,
Welcome to HCM.
Behavioral problems like violent,aggressive behavior, irritability, hallucinatory behavior can occur in patients suffering from organic brain damage.
Your father is old and he has co-morbid medical illness. Hence , he needs supervised medication which has to be adjusted carefully so as to avoid any side-effects. I would recommend that you consult a psychiatrist and start the medications only after a complete medical and neuro-psychiatric evaluation.
Welcome to HCM.
Behavioral problems like violent,aggressive behavior, irritability, hallucinatory behavior can occur in patients suffering from organic brain damage.
Your father is old and he has co-morbid medical illness. Hence , he needs supervised medication which has to be adjusted carefully so as to avoid any side-effects. I would recommend that you consult a psychiatrist and start the medications only after a complete medical and neuro-psychiatric evaluation.
I find this answer helpful
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