Hello seniors and colleagues... In a case of Alzheimer’s dementia in an elderly above 80 years with MMSE less than 10, CDR 2, with comorbid DM, HTN and IHD and cogwheel rigidity in both upper limbs, already on Donepezil and Memantine, what options are left to control the aggression?

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Quetiapine 25 mg od,, can gradually increase upto 100 mg

Quetiapine 25 mg increase the dose Psychotherapy & yoga Always talking with him special care of him .

I think quetiapine at low doses is better than other antipsychotics considering its low affinity do dopamine receptors up to 200mg as patient is already having cog wheel rigidity. And along with other side effects care givers should be told about postural hypotension considering increased chances of fall. And other psychological interventions such as cognitive remediation therapy can be used after aggressive behaviour subsides. And few learning principles can be tried for patient though MMSE score is very low.

low dose risperidone with blood sugar monitoring..

any antipsychotic in small doses is helpful

Tb trinicalm plus half bd. Immiadiately aggression comes down. (Trifluperazine 2.5 mg + trihexyphenidil 1 mg )

aripiprazole in low doses can be tried sir, or quetiapine in low doses

I agree with Dr. Sushil Kumar

Psychological management of Dementia

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