ChoiceHub
Sign in
An 83-year-old woman in residential care has advanced Alzheimer disease. Over six weeks she has repeatedly struck staff during personal care and shouts that there are strangers in her room at night. Pain, constipation, infection, hearing loss and medication change have all been excluded, and a four-week structured behavioural and environmental programme has not helped. She has no history of stroke, atrial fibrillation, hypertension or diabetes, and no parkinsonian features or visual hallucinations. Her son, appointed as her enduring guardian, has consented to a trial of antipsychotic treatment. Which one of the following is the most appropriate initial prescription?
Shared by Morniencommon

Keep going — a set of ten like this one, one at a time.

Practise more

More from Psychiatry

See all

A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…

Pre-internship · niche

A 40-year-old man who came to Australia from Iraq as a refugee eight years ago attends a general practice with six months of broken sleep, nightmares and daily…

Clinical rotations · middle twist

A 71-year-old woman who migrated from Hong Kong 40 years ago is admitted to a psychiatric ward with a severe depressive episode. She speaks Cantonese and almost…

Pre-internship · middle twist

A metropolitan mental health service is examining why Aboriginal and Torres Strait Islander inpatients leave the ward against medical advice far more often than…

Clinical rotations · middle twist

A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…

Pre-internship · niche