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

7 answers | Last updated: Oct 25, 2016
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 Answers

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.

Community Answers

Ms terri answered...

Thank you for the info.

Alice baby answered...

My Mom just started on Respirdal about 8 days ago (.5) and her delusions have faded completely. I was extremely opposed to her taking the meds because of the side effects. However, she is more settled and everything appears to be fine. She is groggy throughout the day but again, the delusions were constant and exhausting for her and everyone else.

Ms terri answered...

Thank you for the information. I'll look into it. Her illusions are getting worse.

Alice baby answered...

Ms Teri, I have been looking for a place here in NH for my Mom so that I can be with her more frequently. I have been fortunate to talk to the Directors of the facilities I have been looking into. They have been so thoughtful, compassionate and very helpful. It's amazing how caring these folks are with us! I always insert in the conversation about the new medicine my mom is taking, the Respirdal, and they all say the same--yes, it does have its risks, as all meds do, but it is the ONLY med that will block the delusions! So far, so good with Mum. I will keep you updated in terms of her behaviors. I will be in NJ next week , staying at the facility with my Mum 12-14 hours each day. I will be getting a big picture of what's happening. I am very optimistic! Ms Teri, My thoughts and prayers are with you and your family. It's comforting to know we are not alone and I really like sharing info. I will have much more in a few weeks. Susan

Lani herner bcwp answered...

I am a Board Certified Wellness Practitioner. Besides working with women, I also work with the aging population.

There are two cases in the state of Wisconsin that elderly patients suffering from Dementia were prescribed Risperdal and in the course of 7 days died of complications that developed from the drug.

The black box on the drug clearly states that an elderly patient with Dementia should not be given Risperdal because it will cause death. Dr. Ladislav-volicer-md, have you ever read the black box on this drug?.

I would never dispense this to a patient with dementia. There are many ways to reach out and help a patient who suffers from this debilitating disease. They are suffering enough as it is and the patient does not need the additional stressors to the brain.

Whoever has a family member with Dementia, please research this drug before you make a decision, and always get a second opinion. Ask to see the labels before agreeing to any protocol.

Any doctor that is fine with dispensing this drug specifically for Schizophrenia to elderly patients with Dementia should be researched before taking him on for your families health and wellness

Alz daugh answered...

It may sound cold, but my father is suffering from Alzheimer’s related dementia and has just been prescribed Risperdal 3 days ago. His delusions have subsided and he is easier to manage and redirect. If he were to have a heart attack or stroke tomorrow and die, I would consider it a blessing, as this is NOT the way that he would ever have wanted to live. At this point in his disease, we are now trying to figure out a way to manage his behavior for the rest of his days, which will NEVER be what they were before this awful, cruel disease. After reading some of the responses on this forum, I now understand why my dad’s Dr. thanked me for signing a DNR and Do Not Treat for any life threatening condition that may arise, and to just keep him comfortable. At this point, death of his body so that his spirit can peacefully reside with our Savior will be a blessing.