Antipsychotic medication for elderly people with schizophrenia

Marriott, R. A.; Neil, Wendy; Waddingham, Susie

doi:10.1002/14651858.cd005580

Cited by 31 publications

(12 citation statements)

References 103 publications

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“…Therefore, patients with psychiatric conditions require an especially proactive clinical approach, with clinicians from primary and secondary care working closely in conjunction with one another. The evidence base for clinical practice is primarily drawn from clinical trials, which in most cases have less than one year of follow up [40][41][42][43][44][45]. Further studies examining the long-term effects on CVR factors of antidepressants and antipsychotics are required.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

et al. 2016

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“…Very few studies have been done on those aged more than 65 years, and thus there are inadequate data and evidence to support any guidelines for treatment of late-onset schizophrenia or to serve these older patients’ quality of life, functioning, and service use 105,106…”

Section: Pharmacological Treatment Used In Different Developmental Stmentioning

confidence: 99%

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Chien¹,

Yip²

2013

NDT

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During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients’ needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have recommended that a combination of treatment modalities be adopted to meet the complex health needs of people with schizophrenia spectrum disorders. In view of the heterogeneity of the risk factors and the illness progression of individual patients, the use of multifaceted illness management programs consisting of different combinations of physical, psychological, and social interventions might be efficient and effective in improving recovery.

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“…Although antipsychotics are commonly used in elderly patients, there is a paucity of data regarding use of these medications in geriatric patients with schizophrenia (Jeste et al, 2005;Marriott et al, 2006). Most studies have evaluated elderly patients with dementia-related psychiatric illness, with few studies in geriatric patients with schizophrenia (Jeste et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Long‐term safety and efficacy of long‐acting risperidone in elderly psychotic patients

Kissling

Glue²,

Medori

et al. 2007

Human Psychopharmacology

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This subgroup analysis of the 6-month, open-label Switch to Risperidone Microspheres (StoRMi) trial evaluated long-term safety and efficacy of a direct conversion to risperidone long-acting injectable (RLAI) in 52 elderly patients (> or =65 years) with psychosis stabilized on oral or depot antipsychotic. Study outcomes included adverse events, movement disorder severity, psychiatric symptoms, functional ability, quality of life and patient satisfaction. Change in the Positive and Negative Syndrome Scale at endpoint was the primary efficacy measure. The most common dosage of RLAI used at endpoint was 25 mg every 14 days (60%). The trial was completed by 81% of patients, with six patients discontinuing treatment due to an adverse event. Tolerability was good and most side effects were mild to moderate. Serious adverse events occurred in 11 patients. Two of these (suicidal attempt, n = 1; exacerbation of disease, n = 1) were considered possibly related to RLAI. Conversion to RLAI resulted in significant improvements in movement disorder severity, psychiatric symptoms, functional status and patient satisfaction. Mean PANSS total decreased by 15.8 at endpoint, with 23 patients (46.9%) experiencing a > or =20% improvement. This post-hoc analysis supports that RLAI is well tolerated and safe in elderly patients with psychotic illnesses switched from stable antipsychotic regimens, and suggests possible efficacy, although inferences are limited.

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Antipsychotic medication for elderly people with schizophrenia

Cited by 31 publications

References 103 publications

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Long‐term safety and efficacy of long‐acting risperidone in elderly psychotic patients

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