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Behavioural symptoms of dementia due to pain — SCE Geriatric Medicine MCQ

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HardDementiaBehavioural symptoms of dementia due to painSCE Geriatric Medicine

A care-home resident with Alzheimer disease was started on risperidone during severe aggression associated with pain. Analgesia and environmental interventions have controlled the trigger, and there has been no aggression for 5 weeks. What is the best review plan?

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Correct answer: B — Reassess now and plan withdrawal if there is no clear ongoing benefit, using the lowest dose for the shortest possible time

Explanation lettering: C = shown as A · E = shown as C · A = shown as D · D = shown as E

B is correct: NICE requires the lowest effective dose for the shortest time, review at least every 6 weeks, and stopping when clear ongoing benefit is absent. A extends treatment without review. C delays the first review beyond the recommended interval. D changes drug but removes required review. E makes adverse effects, rather than benefit and current indication, the only stopping test. The original trigger and target symptom must be revisited.

Reference: NICE NG97: dementia: https://www.nice.org.uk/guidance/ng97/chapter/Recommendations