Is Risperdal a bad choice for treating dementia for an 81 year old?

Ms terri asked...

My 81 year old mother had to be moved in with me after my father died last year. She has some dementia, but does pretty good, as long as she takes her Aricept. She's also taking Norvasc, Levothyroxine, Nexium, Paxil and Aspirin-81mg.

I don't know too much about her medical history, just what I've found in the paper work she has. My dad took care of all that.

She gets forgetful of course, but has delusions about bugs eating her face, teeth and eye brows. She thinks they're on her arms too. The psychiatrist prescribed Risperdal (.5mg) to see if it'll stop the delusions. My mom thinks it's real.

I read on the internet that Risperdal shouldn't be given to patients age 71-97 who have dementia-related psychosis, and has caused death in 1.5 patients in a study program. I'm not giving them to her because of that information. The nurse said it was a small dose and that there are side effects to any drug and that it could better her quality of life.

What do you think?

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

Risperdal and other antipsychotics increase slightly the risk of stroke and other side effects. However, they are the only medications that will block your mother's hallucinations. The decision boils down to evaluation of risks and benefits. The benefits of stopping the hallucinations that bother your mother would in my opinion outweigh the risk of side effects of Risperdal. If she were my mother, I would definitely treat her with Risperdal.