... and seizure disorders. Adverseeffectsofmemantinemayinclude:fatigue,pain,dizziness,constipation,anxiety and hallucinations.Table 4. Starting dose and titration schedule of memantineDrug ... events in elderly patients taking risperidone in clinical studies. † TheUSFood and DrugAdministrationissuedahealthadvisory in March2005reportingincreasedmortality(1.6-1.7foldincrease in relativerisk,1.9%increase in absoluterisk,NNH:52) in elderlypatientstakingatypi-calanti-psychoticstotreatBPSD.1414Cognitive ... 2008Nosubjectivecomplaintsofmemorydecit.Nomemorydecitevidentonclinicalinterview.Subjectivecomplaintsofmemorydecit,mostfrequently in followingareas:(a)forgettingwhereonehasplacedfamiliarobjects;(b)forgettingnamesoneformerlyknewwell.Noobjectiveevidenceofmemorydecitonclinicalinterview.Noobjectivedecits in employmentorsocialsituations.Appropriateconcernwithrespecttosymptomatology.Earliestclear-cutdecits.Manifestations in morethanoneofthefollowingareas:(a)patientmayhavebecomelostwhentravelingtoanunfamiliarlocation;(b)co-workersbecomeawareofpatient'srelativelypoorperformance;(c)word and namendingdecitbecomesevidenttointimates;(d)patientmayreadapassageorabook and retainrelativelylittlematerial;(e)patientmaydemonstratedecreasedfacility in rememberingnamesuponintroductiontonewpeople;(f)patientmayhavelostormisplacedanobjectofvalue;(g)concentrationdecitmaybeevidentonclinicaltesting.Objectiveevidenceofmemorydecitobtainedonlywithanintensiveinterview.Decreasedperformance in demandingemployment and socialsettings.Denialbeginstomanifest in thepatient.Mildtomoderateanxietyaccompaniessymptoms.Clear-cutdecitoncarefulclinicalinterview.Decitsmanifest in followingareas:(a)decreasedknowledgeofcurrent and recentevents;(b)mayexhibitsomedecit in memoryofonespersonalhistory;(c)concentrationdecitelicitedonserialsubtractions;(d)decreasedabilitytotravel,handlenances,etc.Frequentlynodecit in followingareas:(a)orientationtotime and place;(b)recognitionoffamiliarpersons and faces;(c)abilitytotraveltofamiliarlocations.Inabilitytoperformcomplextasks.Denialisdominantdefensemechanism.Flatteningofaffect and withdrawalfromchallengingsituationsfrequentlyoccur.Patientcannolongersurvivewithoutsomeassistance.Patientisunableduringinterviewtorecallamajorrelevantaspectoftheircurrentlives,e.g.,anaddressortelephonenumberofmanyyears,thenamesofclosefamilymembers(suchasgrandchildren),thenameofthehighschoolorcollegefromwhichtheygraduated.Frequentlysomedisorientationtotime(date,dayofweek,season,etc.)ortoplace.Aneducatedpersonmayhavedifcultycountingbackfrom40by4sorfrom20by2s.Personsatthisstageretainknowledgeofmanymajorfactsregardingthemselves and others.Theyinvariablyknowtheirownnames and generallyknowtheirspouse’s and children’snames.Theyrequirenoassistancewithtoileting and eating,butmayhavesomedifcultychoosingtheproperclothingtowear.Mayoccasionallyforgetthenameofthespouseuponwhomtheyareentirelydependentforsurvival.Willbelargelyunawareofallrecentevents and experiences in theirlives.Retainsomeknowledgeoftheirpastlivesbutthisisverysketchy.Generallyunawareoftheirsurroundings,theyear,theseason,etc.Mayhavedifcultycountingfrom10,bothbackward and, sometimes,forward.Willrequiresomeassistancewithactivitiesofdailyliving,e.g.,maybecomeincontinent,willrequiretravelassistancebutoccasionallywillbeabletotraveltofamiliarlocations.Diurnalrhythmfrequentlydisturbed.Almostalwaysrecalltheirownname.Frequentlycontinuetobeabletodistinguishfamiliarfromunfamiliarpersons in theirenvironment.Personality and emotionalchangesoccur.Thesearequitevariable and include:(a)delusionalbehavior,e.g.,patientsmayaccusetheirspouseofbeinganimpostor,maytalktoimaginarygures in theenvironmentortotheirownreection in themirror;(b)obsessivesymptoms,e.g.,personmaycontinuallyrepeatsimplecleaningactivities;(c)anxietysymptoms,agitation and evenpreviouslynonexistentviolentbehaviormayoccur;(d)cognitiveabulia,i.e.,lossofwillpowerbecauseanindividualcannotcarryathoughtlongenoughtodetermineapurposefulcourseofaction.Allverbalabilitiesarelostoverthecourseofthisstage.Frequentlythereisnospeechatall,onlyunintelligibleutterances and rareemergenceofseeminglyforgottenwords and phrases.Incontinentofurine,requiresassistancetoileting and feeding.Basicpsychomotorskills,e.g.,abilitytowalk,arelostwiththeprogressionofthisstage.Thebrainappearstonolongerbeabletotellthebodywhattodo.Generalizedrigidity and developmentalneurologicreexesarefrequentlypresent.Level...