Pii: s0140673695912452

While in hospital he was observed to be physically concentrations were 46-4 (2-6) and 22-6 (3-0) for the blue- aggressive. He was first treated with sulpiride and diazepam, green and special-blue groups, respectively (p<0-0001). which led to excessive sedation interspersed with aggressive 24 h 19 of the blue-green group terminated phototherapy, outbursts. He was transferred to a continuing care ward whereas 10 of the special-blue group still needed light where he continued to manifest persecutory delusions and threatening behaviour. He was started on risperidone 0-5 mg The success of blue-green phototherapy is mainly due to once daily and showed much improvement, becoming the combined effects of the increase from blue to green of cheerful and cooperative, and joining in occupational the quantum yield of lumirubin, responsible for the quickest therapy for the first time. He was maintained on risperidone pigment clearance in human beings; a corresponding and after 3 months was sufficiently improved to be referred decrease of ZE-BR quantum yield; and filtering effects of the to the local authority for transfer to a community setting.
skin, which attenuates more blue than green light. Our A 71-year-old man (case 3) with LBD for 6 years results represent the first significant improvement of developed marked visual and auditory hallucinations which phototherapy efficiency following the development and his wife found distressing and difficult to deal with. He introduction of the special-blue lamp by Sisson in 1970, and began attending a day hospital and was started on is based on more than 10 years of interdisciplinary studies risperidone 0-5 mg twice a day. His hallucinations resolved between our groups.1,5 The phototherapy exposure time has and his cognitive functioning improved. There was no now been reduced to 1 day in the majority of preterm determination in his rigid-akinetic syndrome apart from infants, ensuring less stress to the infant and less interference Each patient’s clinical status was assessed at baseline and after 28 days of treatment with the behavioural pathology in *Gian Paolo Donzelli, Simone Pratesi, Gherardo Rapisardi, Alzheimer’s disease rating scale (BEHAV AD),3 which Giovanni Agati, Franco Fusi, Riccardo Pratesi measures behavioural symptoms, delusions, suspiciousness, *Department of Pediatrics, University of Florence, Ospedale Meyer, and hallucinations; the mini mental state examination4 50132 Florence, Italy; Institute of Quantum Electronics, CNR, Forence; andDepartment of Physics, University of Florence (MMSE) to assess cognitive function; and the Webster disability sealer to measure extrapyramidal side-effects. The 1 Donzelli GP, Pratesi R. Progress in phototherapeutic systems for neonatal hyperbilirubinemia. SPIE 1994; 2084: 332-44.
2 Agati G, Fusi F, Donzelli GP, Pratesi R. Quantum yield and skin filtering effects on the formation rate of lumirubin.
J Photochem Photobiol B 1993; 18: 197-203.
3 Vecchi C, Donzelli GP, Migliorini MG, Sbrana G, Pratesi R. New light in phototherapy. Lancet 1982; ii: 390.
4 Pratesi R. Two lights for phototherapy. Lancet 1983; ii: 859.
5 Sisson TRC, Kendall N, Davies RE, Berger D. Factors influencing the effectiveness of phototherapy in neonatal hyperbilirubinemia.
Birth Defects 1970; 6: 100-05.
Risperidone for psychotic and behaviouralsymptoms in Lewy body dementia SIR-Lewy body dementia (LBD) is characterised byprogressive dementia with fluctuation performance, hallucinations, and extrapyramidal features. In addition supersensitivity to neuroleptics is common,’ which We have found risperidone to be an effective treatment of psychotic and behavioural symptoms in these three cases of behavioural and psychotic symptoms that commonly occur LBD. Though cognitive decline is a common complication in LBD problematic. Risperidone is a novel neuroleptic that of neuroleptic treatment in such patients, no such decline acts as an antagonist at D2 and 5 HT receptors. Probably was seen with risperidone. Indeed case 3 showed clinical because of this dual action it has a much lower rate of improvement on the MMSE despite experiencing slight extrapyramidal side-effects than older neuroleptics.2 We worsening in extrapyramidal symptoms. We suggest that describe three patients with LBD (diagnosed by McKeith’s risperidone may be a useful treatment of psychotic and clinical criteria’) whose behavioural disturbances were behavioural symptoms in LBD and warrants controlled treated successfully with small doses of risperidone.
A 78-year-old-old woman (case 1) with a 6-month history of LBD with a rapidly progressing course, striking *R L Allen, Z Walker, Penny J D’Ath, Cornelius L E Katona fluctuation, and prominent visual hallucination became *Department of Psychiatry, Princess Alexandra Hospital, Harlow, Essex CM20 1QX, unmanageable in her residential home and UK; and University College London Medical School, London WC1 hospital. She had developed persecutory delusions, was agitated, constantly wandering, and interfering with other McKeith I, Fairbairn A, Perry R, Thompson P, Perry E. Neuroleptic residents. She had been unsuccessfully treated with sulpiride sensitivity in patients with senile dementia of Lewy body type. BMJ 2 Owens DGS. Extrapyramidal side effects and diazepam, which led to increasing confusion. She was stared on risperidone 0-5 mg once daily and after 2 weeks 3 Reisberg B, Borenstein J, Salob SP, Franssen E, Georgotas A.
was calmer and less distressed with no delusions or Behavioural symptoms in Alzheimer’s disease: phenomenology and hallucinations. After 1 month she had improved sufficiently treatment. J Clin Psychiatry 1987; 48 (suppl): 9-15.
McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the A 66-year-old man (case 2) with a 6-year history of LBD Webster DD. Critical analyses of the disability in Parkinson’s disease.
was admitted to hospital for assessment of poor self care.

Source: http://www.staff.city.ac.uk/~pennyd/007_Risperidone_for_psychotic_and_behavioural_symptoms_in_Lewy_Body_Dementia.pdf