A 76-year-old woman with Alzheimer's disease (MMSE 18/30) presents with a 3-week history of bilateral tremor, shuffling gait, and drooling. She was st...

Question

A 76-year-old woman with Alzheimer's disease (MMSE 18/30) presents with a 3-week history of bilateral tremor, shuffling gait, and drooling. She was started on Risperidone 1 mg at night 6 weeks ago for agitation. What is the MOST appropriate action?

Accepted Answer

Gradually reduce and stop Risperidone as these are likely extrapyramidal side effects, and monitor for improvement over 2-4 weeks

Answer

Increase Risperidone as the symptoms suggest worsening dementia

Answer

Add Procyclidine to manage the Parkinsonian symptoms while continuing Risperidone

Answer

Switch to Haloperidol as it has fewer extrapyramidal effects

Answer

Start Levodopa for the new Parkinsonian symptoms

uk-dgm MCQ (SBA): Drug-Induced Parkinsonism from Risperidone in Dementia

A 76-year-old woman with Alzheimer's disease (MMSE 18/30) presents with a 3-week history of bilateral tremor, shuffling gait, and drooling. She was started on Risperidone 1 mg at night 6 weeks ago for agitation. What is the MOST appropriate action?