Just to tease my favouritist blogging GP, commenting on Secondary Care stopping medication that with hindsight is inappropriate . . .
. . . I was referred a lady with Behavioural and Psychological Symptoms of Dementia. She bit, kicked and punched care staff in her nursing home. She pushed other residents out of the way, causing a fracture in one old lady.
After initiating galantamine and promazine, she improved. A week later on review there was no hostility (not even verbal hostility) and all was well. A month passed. The home was happy. Her husband was happy.
She had a review by her GP who halved her promazine from 4 times a day down to 2 times a day (just morning and night). I know this because the GP 'phoned me to ask for a prompt review this week since she's now screaming like a banshee and flailing at folk with her walking stick through the afternoon and evening when she's no longer receiving her promazine.
Sometimes, just sometimes, us mental health folk do get it right and it's best not to rock the boat :-)