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Suggest Treatment For Severe Episodes Of Hysteria While Having Alzheimer's Disease

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Posted on Wed, 6 Sep 2017
Question: Hi, My mother who is 92 has Alzheimer's, (dx 18 months ago, moderate to severe) and is having increasing periods of hysteria . She recently fell and broke a small bone in her left wrist and has to wear a cast which she hates. She was given a brace but refused to wear it so another cast was put on. Last night she became hysterical was yelling, crying and beating the cast against the well, table and chair. She refused to take tramadol for pain and refused to take 0.5 mg Ativan for anxiety. She remained like this for several hrs. She finally fell asleep at 330am.
This kind of behavior is happening more and more often. Isn't there some kind of med that will help with this kind of behavior? I am not asking for a narcotic.

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Answered by Dr. Sudhir Kumar (41 minutes later)
Brief Answer:
Small dose anti-psychotics may be used.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your mother's clinical details. Based on this, she would benefit from anti-psychotics. I agree that at this age, most medicines would have adverse effects and we need to be very cautious. The lowest possible dose should be used and any side effect should be watched for. Compared to typical anti-psychotics, atypical anti-psychotics have fewer side effects. Drugs such as quetiapine or olanzapine may be used at the lowest possible dose.

Increasing the dose of anti-depressant may not help as currently, she has features of psychosis rather than depression.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

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Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6231 Questions

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Suggest Treatment For Severe Episodes Of Hysteria While Having Alzheimer's Disease

Brief Answer: Small dose anti-psychotics may be used. Detailed Answer: Thank you for posting your query. I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you. I have noted your mother's clinical details. Based on this, she would benefit from anti-psychotics. I agree that at this age, most medicines would have adverse effects and we need to be very cautious. The lowest possible dose should be used and any side effect should be watched for. Compared to typical anti-psychotics, atypical anti-psychotics have fewer side effects. Drugs such as quetiapine or olanzapine may be used at the lowest possible dose. Increasing the dose of anti-depressant may not help as currently, she has features of psychosis rather than depression. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in