Question

60 y/o with depression & paranoia treated with 50mg Zoloft and 6mg risperidone. On follow up pt c/o slow thinking & excessive salvation. On PE masked faces and cogwheel rigidity present. Mood and paranoia have greatly improved. What is the next step?

Answer 1

The next step for the patient is to adjust the medication dosage or consider alternative medications.

Step-by-step explanation:

The next step for the patient is to adjust the medication dosage or consider alternative medications.

The symptoms described, slow thinking, excessive salvation, masked faces, and cogwheel rigidity, suggest the possibility of side effects from the current medication regimen. These side effects are consistent with serotonin syndrome, a potentially dangerous condition that can occur when serotonin levels in the brain are too high. In this case, reducing the dosage of Zoloft and/or risperidone may improve the symptoms while still maintaining the benefits of these medications.

Alternatively, the doctor could consider switching the patient to a different medication that may be better tolerated. Close monitoring by the healthcare provider is essential to ensure the safety and well-being of the patient throughout this process.