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Risperidone for AIDS-associated dementia: a case series
1Linroc Nursing Home, Brookdale Medical Center, Brooklyn, NY, USA.
AIDS Patient Care and Stds
|August 1, 1996
Summary
Low-dose risperidone effectively managed behavioral disturbances in most patients with AIDS dementia. This offers a potential alternative for those susceptible to movement disorders or unresponsive to other treatments.
Area of Science:
- Neuroscience
- Geriatric Psychiatry
- Infectious Disease Psychiatry
Background:
- Behavioral disturbances are common in AIDS dementia, often treated with neuroleptics.
- Conventional neuroleptics carry a high risk of movement disorders in this population due to the virus's effect on the basal ganglia.
- Low-dose risperidone presents a potentially safer alternative with a lower risk of movement disorders.
Observation:
- Nine nursing home patients with AIDS dementia were treated with low-dose risperidone (0.5-1 mg/day).
- Most patients received adjunctive psychiatric medications.
- Follow-up periods ranged from 2 weeks to 4 months.
Findings:
- Six of nine patients showed improved mood, reduced agitation and aggression, and increased cooperation within a week.
- Two patients experienced worsening agitation or psychosis, requiring discontinuation of risperidone.
- One patient developed increased paranoia and hallucinations, necessitating transfer to a psychiatric unit.
Implications:
- Low-dose risperidone effectively controlled behavioral disturbances in 66% of patients with AIDS dementia.
- Risperidone may be a viable alternative to conventional neuroleptics for managing behavioral symptoms in patients with AIDS dementia, especially those at high risk for movement disorders.
- Further research is warranted to optimize risperidone use in this vulnerable population.