Expert: Paula Damgaard - 12/31/2006

Question
My dad doesn't recognize me, but usually recognizes my mom.  He's almost 81 and in relatively good health...years ago had a single by-pass and has a pretty good appetite, as long as none of the food is hard. He used to cry occasionally, but now it is everyday, unconsolably - sobbing to the point of being left breathless.  Doctor has started him on Risperdal (.25 mg, 1 in a.m. and 1 in p.m.)  He sits like a vegetable...droopy eyes, drools and recognizes no one...not even my mom!  My questions: what stage is this; should his Risperdal be halved and are his crying jags better than being in this state.  I live in another state and this is so difficult for my mom.  I appreciate your opinion.

Answer
Hi Peg, sorry for the delay, it has been kind of hectic around here with the holidays.  

My first question is does he really have AD or does he have a vascular dementia?  The reason I ask this is because a lot of people who have heart surgery end up with a VD rather than AD and with his emotional aspect this is pretty typical of VD. Not that this is "curable" but it could be that he had either a group of small strokes which have affected his emotional center.  Often times the use of an antidepressant helps to calm this down.  Is he on any?  Effexor XR is one that we recommend or Paxil.  That could help his crying spells.  

As to what stage this is it is hard to say without knowing more about him, and it really doesn't matter, cause the stage that he is in today is the stage that your mom has to deal with.  Whether or not it is AD or VD, there are no staging that is totally specific to an individual.  

I would think that if he isn't on an antidepressant, that putting him on one and cutting back on the Risperdal would help to get him out of his grog and hopefully stop the crying.  I hope this helps.  Let me know how it goes.  I hope your family was able to enjoy some of the holiday cheer.  Paula