11-30-2010, 08:57 AM
A 60-year-old male with a history of chronic schizophrenia
and multiple hospitalizations checks into
the emergency room with complaints of “funny
movements.” He has been compliant with risperidone
(Risperdal) 3 mg bid, and he has been taking
that dose for the last 6 years while living at a group
home. He appears overweight but with adequate
hygiene. His thoughts are somewhat tangential but
not grossly disorganized. He denies any paranoia,
ideas of reference, or delusions. He denies perceptual
disturbances or suicidal/homicidal ideation.
His physical examination is unremarkable except
for occasional involuntary blinking and grimacing,
as well as rotation of his left ankle. He is greatly distressed
about these “habits” and wishes something
to be done about them.
Which of the following would be the most
appropriate management for this patient?
(A) add benztropine to the risperidone
(B) continue the current dose of risperidone
© decrease the dose of risperidone
(D) discontinue the risperidone
(E) increase the dose of risperidone
and multiple hospitalizations checks into
the emergency room with complaints of “funny
movements.” He has been compliant with risperidone
(Risperdal) 3 mg bid, and he has been taking
that dose for the last 6 years while living at a group
home. He appears overweight but with adequate
hygiene. His thoughts are somewhat tangential but
not grossly disorganized. He denies any paranoia,
ideas of reference, or delusions. He denies perceptual
disturbances or suicidal/homicidal ideation.
His physical examination is unremarkable except
for occasional involuntary blinking and grimacing,
as well as rotation of his left ankle. He is greatly distressed
about these “habits” and wishes something
to be done about them.
Which of the following would be the most
appropriate management for this patient?
(A) add benztropine to the risperidone
(B) continue the current dose of risperidone
© decrease the dose of risperidone
(D) discontinue the risperidone
(E) increase the dose of risperidone