Distressed elderly patients — especially those with dementia — frequently have a paradoxical reaction to benzodiazepines, causing extremely agitated states. Men with type A personalities are at greatest risk.

Administering risperidone (Risperdal), quetiapine (Seroquel) or haloperidol (Haldol) will control agitation. If sedation is required, a benzodiazepine can be safely added 30 to 45 minutes later. — Leslie de la Flor, NP, Anaheim, Calif. (162-5)

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