Treatment of schizophrenia and delusional disorder in the elderly
Tóm tắt
With increasing longevity, greater numbers of patients with schizophrenia and delusional disorder will be surviving into advanced age. Antipsychotics form the core of the treatment for both of these psychotic disorders. Treatment of elderly patients with antipsychotics is, however, complicated by a much higher risk of adverse effects such as tardive dyskinesia. More is known about treating patients with schizophrenia than those with delusional disorder. The introduction of newer atypical antipsychotics may herald a new era in the pharmacotherapy of elderly psychotic patients. Nonetheless, judicious dosing is essential in the geriatric population. We discuss the benefits and limitations of the main forms of treatment.
Tài liệu tham khảo
Jeste DV, Harris MJ, Krull A, Kuck J, McAdams LA, Heaton R (1995) Clinical and neuropsychological characteristics of patients with late-onset schizophrenia. Am J Psychiatry 152:722–730
Roth M (1995) The natural history of mental disorder in old age. J Ment Sci 101:281–301
Kay DWK, Roth M (1961) Environmental and hereditary factors in the schizophrenias of old age (“late paraphrenia”) and their bearing on the general problem of causation in schizophrenia. J Ment Sci 107:649–686
Kay DWK, Beamish P, Roth M (1964) Old-age mental disorders in Newcastle-Upon-Tyne. Br J Psychiatry 110:146–158
Bleuler M (1943) Late schizophrenic clinical pictures. Fortschr Neurol Psychiatry 15:259–290
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Press, Washington, DC
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (Dsm-III-R), 3rd edn, revised. American Psychiatric Press, Washington, DC
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Maurer K, Häfner H (1995) Methodological aspects of onset assessment in schizophrenia. Schizophr Res 15:265–276
Harris MJ, Jeste DV (1988) Late-onset schizophrenia: an overview. Schizophr Bull 14:39–55
Corey-Bloom J, Jernigan T, Archibald S, Harris MJ, Jeste DV (1995) Quantitative magnetic resonance imaging in late-life schizophrenia. Am J Psychiatry 152:447–449
Ciompi L (1980) Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophr Bull 6:606–618
Winokur G (1977) Delusional disorder (paranoia). Compr Psychiatry 18:511–521
Kendler S, Davis KL (1981) The genetics and biochemistry of paranoid schizophrenia and other paranoid psychoses. Schizophr Bull 7:689–709
Gurian BS, Wexler D, Baker EH (1992) Late-life paranoia: possible association with early trauma and infertility. Int J Geriatr Psychiatry 7:277–284
Flint AJ, Rifat SI, Eastwood MR (1991) Late-onset paranoia: distinct from paraphrenia? Int J Geriatr Psychiatry 6:103–109
Miller BL, Benson FD, Cummings JL, Neshkes R (1986) Latelife paraphrenia: an organic delusional system. J Clin Psychiatry 47:204–207
Rockwell E, Krull AJ, Dimsdale J, Jeste DV (1994) Late-onset psychosis with somatic delusions. Psychosomatics 35:66–72
Evans JD, Paulsen JS, Harris MJ, Heaton RK, Jeste DV (1996) A clinical and neuropsychological comparison of delusional disorder and schizophrenia. J Neuropsychiatr Clin Neurosci 8:281–286
Rowell FJ, Hui SM, Fairbairn AF, Eccleston D (1980) The effect of age and thioridazine on the in vitro binding of fluphenazine to normal human serum. Br J Clin Pharmacol 9:432–433
Honigfeld G, Rosebaum MP, Blumenthal IJ, Lambert HL, Roberts AJ (1965) Behavioral improvement in the older schizophrenic patient: drug and social therapies. J Am Geriatr Soc 13:57–71
Tsuang MM, Lu LM, Stotsky BA, Cole JO (1971) Haloperidol versus thioridazine for hospitalized psychogeriatric patients: double-blind study. J Am Geriatr Soc 19:593–600
Branchey MH, Lee JH, Ramesh A (1978) High- and low-potency neuroleptics in elderly psychiatric patients. J Am Mod Assoc 239:1860–1862
Rabins P, Pauker S, Thomas J (1984) Can schizophrenia begin after age 44? Compr Psychiatry 25:290–293
Jeste DV, Harris MJ, Pearlson GD, Rabins P, Lesser I, Miller B, Coles C, Yassa R (1988) Late-onset schizophrenia: studying clinical validity. Psychiatr Clin North Am 11:1–14
Jeste DV, Lacro JP, Gilbert PL, Kline J, Kline N (1993) Treatment of late-life schizophrenia with neuroleptics. Schizophr Bull 19 (4):817–830
Opjordsmoen J (1988) Hypochondriacal psychoses: a longterm follow-up. Acta Psychiatr Scand 77:587–597
McCoy LM, Schwarzkopf SB, Martin D (1992) Rapid response to pimozide in treatment resistant delusional disorder. Ann Clin Psychiatry 4:95–98
Ungvari GS, Hollokoi RIM (1993) Successful treatment of litigious paranoia with pimozide. Can J Psychiatry 38:4–8
Raskind M, Alvarez C, Herlin S (1979) Fluphenazine enthanthate in the outpatient treatment of late paraphrenia. J Am Geriatr Soc 27:459–463
Chiu HF (1995) Delusional jealousy in Chinese elderly psychiatric patients. J Geriatr Psychiatry Neurol 8:49–51
Songer DA, Roman B (1996) Treatment of somatic delusional disorder with atypical antipsychotic agents. Am J Psychiatry 153:578–579
Oberholzer AF, Hendriksen C, Monsch AU, Heierli B, Stahelin HB (1992) Safety and effectiveness of low-dose clozapine in psychogeriatric patients: a preliminary study. Int Psychogeriatr 4:187–195
Chengappa KNR, Baker RW, Kreinbrock SB, Adair D (1995) Clozapine use in female geriatric patients with psychoses. J Geriatr Psychiatry Neurol 8:12–15
Salzman C, Vacarro B, Lieff J, Weiner A (1995) Clozapine in older patients with psychosis and behavioral disruption. Am J Geriatr Psychiatry 3:26–33
Pitner JK, Mintzer JE, Pennypacker LC, Jackson CW (1995) Efficacy and adverse effects of clozapine in four elderly psyschotic patients. J Clin Psychiatry 56:180–185
Borison RL, Davidson M, Berman I (1994) Risperidone treatment in elderly patients with schizophrenia or dementia (Poster). APA 46th Institute of Hospital and Community Psychiatry (Abstract)
Jeste DV, Eastham JH, Lacro JP, Gierz M, Field MG, Harris MJ (1996) Management of late-life psychosis. J Clin Psychiatry 57:39–45
Jeste DV, Eastham JH, Gierz M, Field MG, Morgenstern M, Lacro JP (1997) Use of risperidone in the elderly. In: Ayd F (ed) The art of rational risperidone therapy. Ayd Medical Communications, Baltimore, pp 147–167
Berman I, Merson A, Rachov-Pavlov J, Allan E, Davidson M, Losonczy MF (1996) Risperidone in elderly schizophrenic patients. Am J Geriatr Psychiatry 4:173–179
Stip E, Lussier I (1996) The effect of risperidone on cognition in patients with schizophrenia. Can J Psychiatry 41:35S-40S
Frankenburg FR, Kalunian D (1994) Clozapine in the elderly. J Geriatr Psychiatry Neurol 7:129–132
Madhusoodanan S, Brenner R, Araujo L, Abaza A (1995) Efficacy of risperidone treatment for psychoses associated with schizophrenia, schizoaffective disorder, bipolar disorder, or senile dementia in 11 geriatric patients: a case series. J Clin Psychiatry 56:514–518
Sajatovic M, Ramirez LF, Vernon L, Brescan D, Simon M, Jurjus G (1996) Outcome of risperidone therapy in elderly patients with chronic psychosis. Int J Psychiatry Med 26:309–317
Levy RH (1996) Sedation in acute and chronic agitation. Pharmacotherapy 16:152S-159S
Tune LE, Bylsma FW (1991) Benzodiazepinie-induced and anticholinergic-induced delirium in the elderly. Int Psychogeriatrics 3:397–408
Thienhaus OJ, Allen A, Bennett JA, Chopra YM, Zemlan FP (1990) Anticholinergic serum levels and cognitive performance. Eur Arch Psychiatry Clin Neurosci 240:28–33
48.Tollefson G, Montague-Clouse J, Lancaster SP (1991) The relationship of serum anticholinergic activity to mental status performance in an elderly nursing home population. J Neuropsychiatr Clin Neurosci 3:314–319
Tune L, Carr S, Hoag E, Cooper T (1992) Anticholinergic effects of drugs commonly prescribed for the elderly: potential means for assessing risk of delirium. Am J Psychiatry 149 (10):1393–1394
Ames D, Wirshing WC, Marder SR (1996) Advances in antipsychotic pharmacotherapy: clozapine, risperidone, and beyond. Essent Psychopharmacol 1:5–26
Gershanik OS (1994) Drug-induced parkinsonism in the aged. Drugs Aging 5:127–132
Campbell AJ (1991) Drug treatment as a cause of falls in old age: a review of the offending agents. Drugs Aging 1:289–302
Kane JM, Jeste DV, Barnes TRE, Casey DE, Cole JO, Davis JM, Gualtieri CT, Schooler NR, Sprague RL, Wettstein RM (1992) Tardive dyskinesia: a Task Force Report of the American Psychiatric Association. American Psychiatric Association, Washington, DC
Jeste DV, Caligiuri MP, Paulsen JS, Heaton RK, Lacro JP, Harris MJ, Bailey A, Fell RL, McAdams LA (1995) Risk of tardive dyskinesia in older patients: a prospective longitudinal study of 266 patients. Arch Gen Psychiatry 52:756–765
Eastham JH, Lacro JP, Jeste DV (1996) Ethnicity and movement disorders. Mt Sinai J Med 63(5/6):314–319
Caligiuri MP, Lacro JP, Rockwell E, McAdams LA, Jeste DV (1997) Incidence and risk factors for severe tardive dyskinesia in older patients. Br J Psychiatry (in press)
Lohr LB, Browning JA (1995) Free radical involvement in neuropsychiatry illnesses. Psychopharmacol Bull 31:159–165
Stimmel GL (1996) Benzodiazepines in schizophrenia. Pharmacotherapy 16:1485–1515
Lerner Y, Mintzer Y, Schestatzky M (1988) Lithium combined with haloperidol in schizophrenic patients. Br J Psychiatry 153:359–362
Terao T, Oga T, Nozaki S, Ohta A, Ohtsubo Y, Yamamoto S, Zamami M, Okada M (1995) Lithium addition to neuroleptic treatment in chronic schizophrenia: a randomized, double-blind, placebo-controlled, cross-over study. Acta Psychiatr Scand 92:220–224
Miller F, Menninger J, Whitcup SM (1986) Lithium-neuroleptic neurotoxicity in the elderly bipolar patient. J Clin Psychopharmacol 6:176–178
Pary R, Tobias CR, Lippmann S (1995) Chronic schizophrenia. Options for pharmacologic management. Postgrad Med 98:163–173
Morinigo A, Martin J, Golzalez S, Mateo I (1989) Treatment of resistant schizophrenia with valproate and neuroleptic drugs. Hillside J Clin Psychiatry 11:199–207
Altamura AC, Basile R, Mauri M, Cazzullo CL (1986) Valpromide (Depamide) in the treatment of acute psychotic states. Open clinical study. Acta Psychiatr Belg 86:297–304
Weiden P, Rapkin B, Mott T, Zygmunt A, Goldman D, Horvitz-Lennon M, Frances A (1994) Rating of medication influences (ROMI) scale in schizophrenia. Schizophr Bull 20:297–310
Patterson LE (1996) Strategies for improving medication compliance. Essent Psychopharmacol 1:70–79
Remington GJ, Jeffries JJ (1994) Erotomanic delusions and electroconvulsive therapy: a case series. J Clin Psychiatry 55:306–308
Wolters EC, Jansen ENH, Tuynman-Qua HG, Bergmans PLM (1996) Olanzapine in the treatment of dopaminomimetic psychosis in patients with Parkinson’s disease. Neurology 47:1085–1087
Buckley P, Cutler N, Silber C, O’Neil J, Mack R (1997) The safety and tolerability of sertindole in elderly patients with dementia. Schizophr Res 24:201
Tariot PN, Arvanitis LA (1997) Efficacy, safety, and tolerability of quetiapine in elderly subjects with psychotic disorders. Abstracts of the American Association of Geriatric Psychiatry 10th Annual Meeting and Symposium, Orlando, Fla 88