Clozapine, olanzapine and, to a lesser extent, quetiapine may cause sedation, anticholinergic effects and orthostatic hypotension. Quetiapine has not been studied in the elderly. 18 How this drug compares with other newer antipsychotics remains to be established. 19 Risperidone is well tolerated, 18 and several studies have demonstrated its efficacy in the management of psychotic and aggressive symptoms in patients with dementia. 18 , 20 Risperidone, in dosages of to mg per day, has successfully alleviated behavioral disturbances in patients with Alzheimer's disease. 21 , 22 Clozapine is somewhat more difficult to use because of its association with agranulocytosis and the need for periodic monitoring of complete blood counts.
Anti-Parkinson Agents (Dopamine Agonist): May diminish the therapeutic effect of Antipsychotic Agents (First Generation [Typical]). Antipsychotic Agents (First Generation [Typical]) may diminish the therapeutic effect of Anti-Parkinson Agents (Dopamine Agonist). Management: Avoid concomitant therapy if possible and monitor for decreased effects of both agents when these combinations cannot be avoided. Atypical antipsychotics such as clozapine and quetiapine may be less likely to reduce the effects of anti-Parkinson agents. Consider therapy modification
I can have quite the silver tongue. I’ve talked my way out of muggings, arrests, arguments etc. The art of communique and semantics are more complex than rocket science; not just delivering ideas – rather, presenting the right stimuli to achieve the desired results. Which brings me to the problem I have.
For 10 years I lied and manipulated my significant other. Nothing terrible or heinous, just a vast patchwork of small to complex lies and omissions in order to maintain optimal happiness for my partner. Note: For my partner, not for the relationship, let alone me. The commitment to my fabrications has fractured my personality, destroyed my self worth, and turned me into a slave within my own mental prison.
Then one day I quit telling her what she wanted to hear – specifically during an argument over wanting to call her back because I dont like using the phone while driving. I avoided, what would have been, a very fatal accident. I was very shaken. I could barely talk, I couldn’t blink, I couldn’t move. When she still refused to give me a breathe – I went off on her. I finally broke free of my cell. I was yelling so loud that everything in my vision was the color purple or blue.
Ever since that night, I quit telling her what she wants to hear. But when I do; I get a terrible stutter. Just this morning it took me about an hour to describe my error in budgeting which led to my phonebill being left out.
For awhile, I thought I had a stroke that night I described. The stutter will only happen when I have to tell her something that I know will upset her though. I couldn’t figure out this new depth of my insanity until reading this article.