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Generally, dementia-related behavior problems (eg, wandering, yelling, uncooperativeness) do not respond to antipsychotics.
When an antipsychotic is used, the starting dose should be about one quarter the usual starting adult dose and should be increased gradually with frequent monitoring for response and adverse effects.
Coxibs, as a class, appear to increase risk of cardiovascular events, but risk may vary by drug; they should be used cautiously.
Short-acting dihydropyridines (eg, ) may increase mortality risk and should not be used.As described in see Table: Potentially Inappropriate Drugs in the Elderly (Based on the American Geriatrics Society 2012 Beers Criteria Update), is not recommended in elderly patients because of the increased risk of hypoglycemia and of hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH).Risk of hypoglycemia is also greater with and can be effective given alone or with sulfonylureas.Antipsychotics should be considered for behavior problems only when nonpharmacologic options have failed and patients are a threat to themselves or others.Treatable causes of insomnia should be sought and managed before using hypnotics (see also Approach to the Patient With a Sleep or Wakefulness Disorder : Hypnotics).