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1. A 72-year-old woman enters the hospital having lost 7 kg and saying she has no interest in eating. Her physical examination and laboratory findings are normal. She has been awakening at 5 a.m. for several months and cannot fall back to sleep. She says she has been feeling anxious and helpless since her husband died 3 years ago. Which one of the following is a reasonable medication to prescribe for her?
1) olanzapine (Zyprexa®)
2) venlafaxine (Effexor®)
3) clonazepam (Rivotril®)
4) quetiapine (Seroquel®)
5) risperidone (Risperdol®)
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Use in elderlyCiting an increased risk of stroke, in 2004 the Committee on the Safety of Medicines (CSM) in the UK issued a warning that olanzapine and risperidone, both atypical antipsychotic medications, should not be given to elderly patients with dementia. In the U.S., olanzapine comes with a black box warning for increased risk of death in elderly patients. It is not approved for use in patients with dementia-related psychosis
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Answer is 3.
First of all, these symptoms are all normal for an elderly person. The anxiety is part of normal grievance. To help her sleep you can give her Clonazepam. The rest of the meds are anti-psychotic, except for Effexor which is used for depression, and she certainly is not clinically depressed.
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Why not
1 Olanzapine since common off-label uses of olanzapine include the treatment of eating disorders (e.g. anorexia nervosa) and as an adjunctive treatment for major depressive disorder without psychotic features. It has also been used for Tourette syndrome and stuttering.[14] Olanzapine is also used in many addiction clinics as a sleep aid (usually 2.5–5 mg) due to its low abuse profile and zero addictive properties.
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hope less and helpless weight loss 7 kg cant be normal even for elderly .but giving antipsychotic for what ?what r the signs of psychosis in this patient ?depression sounds better for this patient .what is the answer docfinish?
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222 she has depression not psychosis
