LAUSR

about 5 to 6 years ago, but discontinuing the medication secondary to excessive sedation. In addition, he reported taking fluoxetine 25 years ago transiently for a few weeks; he reported discontinuing the psychotropic medication secondary to adverse sexual effects. The veteran reported drinking alcohol and indulging in marijuana recreationally during his time in Vietnam. He denies any recreational drug use since 1977. He reported drinking 1 to 2 alcohol beverages yearly. Veteran denies any alcohol usage over the past 18 months. His Mini Mental Status Exam score prior to his disinhibition episode was 27. The patient and his family could establish a temporal relationship with the disinhibition symptoms and administration of 0.5 mg of clonazepam. Subsequently, the patient was tapered off clonazepam over 2 weeks, and disinhibition symptoms subsided. The veteran scored 7 on the Naranjo algorithm, indicating a probable adverse drug reaction. The sleep medicine physician prescribed olanzapine 10 mg by mouth, which led to resolution of his RBD. Olanzapine was started during the benzodiazepine taper to obtain consolidated sleep and mood stability and potentially improve CPAP adherence due to its soporific effect. Olanzapine was deemed to be a safe alternative given the veteran showed no evidence of cognitive impairment. Based on his Mini Mental Status Exam score and clinical evaluation, he demonstrated no significant problems with memory, language, thinking, or judgment that were greater than normal age-related changes.