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The use of risperidone in severely demented patients with persistent vocalizations
1Department of Psychiatry, Dalhousie University, Canada.
Objective:
The hypothesis being tested was that low doses of risperidone would diminish persistent, purposeless vocalizations in two severely demented geriatric women. A secondary hypothesis was that the severe tardive dyskinesia observed in one patient would improve after risperidone treatment.
Design:
An intrasubject on-off-on design was employed.
Setting:
A chronic care facility in Canada.
Subjects:
Two inpatients with DSM-IV (American Psychiatric Association) diagnosis of combined Alzheimer vascular dementia.
Measures:
Nursing assessment of frequency of vocalizations. Extrapyramidal System Rating Scale (ESRS) and Folstein Mini Mental State Examination (MMSE).
Results:
With risperidone treatment, the vocalizations diminished to less than 20% of baseline ratings. For the patient with dyskinesia, ESRS dyskinetic movement scores decreased (baseline = 27; after risperidone 8 weeks = 16). No change was observed for the MMSE.
Conclusions:
The findings support the main hypothesis. The secondary hypothesis was also supported. Further studies of larger numbers of subjects are required to substantiate these preliminary findings.