Journal article
Acute treatment of psychotic symptoms in a newly diagnosed Lewy body dementia patient with an accelerated titration schedule of rivastigmine and de-escalation of antipsychotics
BMJ case reports, Vol.12(9), p.e230193
09/01/2019
DOI: 10.1136/bcr-2019-230193
PMCID: PMC6731943
PMID: 31488443
Abstract
A 76-year-old man presented with complaints of increased confusion, visual hallucinations and decline in memory. He was admitted to the hospital and started on quetiapine 50mg daily for symptom management. Shortly after, he was diagnosed with Lewy body dementia and started on rivastigmine, a cholinesterase inhibitor (ChEI), at 1.5mg two times per day. The patient's symptoms continued to worsen and antipsychotics increased for aggressive behaviour. After he became physically aggressive, an extensive medication management review was conducted, prompting an alternative treatment strategy. The quetiapine dose was reduced from 150mg daily to 12.5mg daily, his rivastigmine was increased to 3mg two times per day and all other antipsychotics were discontinued. The up-titration of his rivastigmine after 10 days of therapy was well tolerated with no adverse effects. He demonstrated a clear clinical response to optimised ChEI therapy and low dose quetiapine, showing improvements in alertness and functioning.
Details
- Title: Subtitle
- Acute treatment of psychotic symptoms in a newly diagnosed Lewy body dementia patient with an accelerated titration schedule of rivastigmine and de-escalation of antipsychotics
- Creators
- Rebecca Nicole Burgett - University of IowaThomas Michael Farley - Univ Iowa, Coll Pharm, Pharm Practice & Sci, Iowa City, IA 52242 USALori Ann Beireis - Mercy Iowa City (Iowa City)
- Resource Type
- Journal article
- Publication Details
- BMJ case reports, Vol.12(9), p.e230193
- Publisher
- Bmj Publishing Group
- DOI
- 10.1136/bcr-2019-230193
- PMID
- 31488443
- PMCID
- PMC6731943
- ISSN
- 1757-790X
- eISSN
- 1757-790X
- Number of pages
- 4
- Language
- English
- Date published
- 09/01/2019
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984366014502771
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