Ideas for med for MR/Psych pt?

[nurseinmo]

I work in an MRDD long term care facility that is operated by the state and we have an individual who is somewhat MR but also has numerous other issues. He had been on Clozaril but had to be taken off due to agranulocytosis. We went through months and months of decreasing the dosage and trying to find a "happy medium" with it but his WBC finally got too low and he was removed from it all together. Currently he is on Haldol (both oral and IM), phenobarb (seizures), topamax....I can't remember what all else. He has been on Mellaril in the past as well as Thorazine, Abilify, and Risperdal that I can think of. We had a recent brief stint on Valium but NOTHING is working. Right now, he won't take any pills that are white (he thinks we are poisoning him) and half the time he won't eat and is already underweight. His behaviors have never been "good" but he was much more controlled on the Clozaril. The Dr. is going to wean him off the Haldol and try Prolixin next; but after that no one knows what else to do for him. Sometimes when I am giving meds and he is upset and starts with the "I'm not taking any of those **** white pills" I can talk to him before I punch them out and explain *sort of* what each one is for... this one is for your blood pressure, this one is for your heart.... and sometimes he will take them, and sometimes he won't. Today, he hasn't taken any meds all day....

Any ideas about newer meds that may help this poor guy?