Paliperidone palmitate offers some advantages in terms of tolerability, simplicity of treatment initiation and long duration between injections. The consensus of the authors is that rather than reserving paliperidone palmitate for use in difficult-to-treat or refractory patients, it could be used to promote adherence and prevent relapse earlier in the course of the illness.

In this report, we demonstrate through a putative case that Dementia with Lewy Bodies (DLB) can present with a catatonic syndrome which can pose diagnostic and management challenges. The patient was an 88-year-old gentleman presenting with acute psychotic and catatonic symptoms on a background of 5 months of functional decline. He showed good response of catatonic symptoms to Clonazepam and psychotic symptoms to Olanzapine. This led to resolution of behavioral problems and the establishment of a putative diagnosis of DLB.Patients with DLB may present with catatonic states; benzodiazepines help resolve catatonic symptoms and facilitate assessment in such patients; and Olanzapine effectively treats psychotic symptoms in DLB.

The findings indicate that the nurse practitioner role can potentially initiate safe and effective mental health care and treatment that is as satisfying as that initiated by a physician. Additional, larger-scale research is required to determine the generalizability of these findings.

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