Patient on Effexor 225 for over 20 years. Haldol 5 for prn agitation. Originally was on Seroquel 25-100mg for sleep which had been working for sleep. Increasingly more depressed lately. Stressors: change in autonomy do to age. Not in therapy or intetested. Switched to Mirtazapine for sleep 15mg in effective. Had been complaing of sob. Has echo scheduled. Has started physical therapy. Pcp thinks he may have parkinsons. Bp has recently been elevated. I know effexor can raise it but hasnt in 20 years. Shuffling gate has caused two falls. Advised to use walker. Has become incontinent. Seemingly secondary to gait. Has trialee trazodone, seroquel, melatonin for sleep. Caregiver says he is just up all night may nap in the am. Recommendations