THE USE OF RISPERIDONE IN SEVERELY DEMENTED PATIENTS WITH PERSISTENT VOCALIZATIONS

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. © 1997 by John Wiley & Sons, Ltd.