'How I Treat:' Managing Irritability Treatment Through Collaboration Case Presentation

The patient is a 70-year-old female who presents to the office with her husband of 40 years and caregiver. The patient is a retired dry cleaner owner who has a past medical history of dementia, mood disorder, gastroesophageal reflux disease (GERD), and hypertension. The patient’s husband expresses concerns of increased “frustration and irritability” for the past 6 weeks, along with increased symptoms of insomnia. The patient has no other complaints and maintains appetite and hydration. Vital signs are unremarkable during examination today. 

Her current medications include:
o    Aricept 10 mg nightly
o    Seroquel 50 mg daily
o    Trazodone 50 mg nightly
o    Pantoprazole 20 mg daily

While the patient is calm during the visit and has no complaints, the patient’s husband expresses concern with the patient’s newly developed symptoms of irritability. The patient has also been having feelings that her husband has been “talking to one of my old girlfriends from college” who has been known to be deceased for the past 5 years.

The patient admits to having increased agitation and issues with sleeping at night. 

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