We are consulted to evaluate the patient' neuropsychitric pharmacotherapy, givne that he is to receive TPN and planned NPO for 1-2 weeks. The patient has retired from (未受教育,不識字) 建築工地工作. In his late 60's, he developed sleep disturbance,multiple pain over limbs, low back pain and headachae( 建築工程, 需長期負重), anxious and low mood. He had been treated with buspirone and trazodoen for anxieyt and sleep disturtbance. He has received outpatient treatment oin our neurology clinic (東區分院楊玉婉醫師), regularly taking donepizil 1# HS, trazodone (25) 2# HS, paroxetine (20) 1.5 # HS, zopiclone (7.5) 1# HS, and valproate (500) 0.5# bid PO. In 2016, he was diagnosed of dementia with depression. Long term ultracet or trmamadol was used for his chronic pain. Brain imageing study did not show feature of vascular lesion excpet artheroscelrosis of internal carotid artery and right vertobrobasilar hypoplasia.