Prospects for the Development of Safer Antipsychotic Agents for the Treatment of the Elderly

1985 ◽  
pp. 339-347
Author(s):  
John M. Kane
Keyword(s):  
Antipsychotic Agents ◽  
The Elderly

scholarly journals Sinus node dysfunction due to psychotropic agents' combination

2012 ◽  
Vol 24 (4) ◽  
pp. 247-250
Author(s):  
József Simkó ◽  
Gabriella Nagy ◽  
Anikó Dózsa ◽  
István Lörincz
Keyword(s):  
Drug Therapy ◽  
Psychotropic Drug ◽  
Sinus Node ◽  
Bipolar Affective Disorder ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
Sinus Node Dysfunction ◽  
Increased Risk ◽  
Psychotropic Agents ◽  
Pharmacologic Agents

Background: Although sinus node dysfunction is primarily related to degenerative fibrosis of nodal tissue in the elderly, it may occur at any age secondary to other cardiac abnormalities or extrinsic causes. Pharmacologic agents including psychotropic drug therapy may also play a role.Method: We present the case of a 53-year-old woman with bipolar affective disorder in whom antipsychotic agents were suspected of inducing sinus node dysfunction.Result: The combination of psychotropic agents including lithium, quetiapine and carbamazepine (first occasion) or escitalopram (second occasion) has been implicated as a cause for sinus node dysfunction.Conclusion: Patients with severe mental illness usually require long-term psychotropic drug therapy, often in combination. This may enhance efficacy but also involves an increased risk of adverse effects including cardiotoxicity.

Risperidone in the treatment of psychoses in the elderly: a case report series

2002 ◽  
Vol 17 (2) ◽  
pp. 96-103 ◽  
Author(s):  
R. Bullock ◽  
S. Libretto
Keyword(s):  
Side Effects ◽  
Elderly Patients ◽  
Negative Symptoms ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Continuous Treatment ◽  
Atypical Antipsychotic Agents

SummaryRisperidone is one of the newer atypical antipsychotic agents, which combines potent serotonin and dopamine receptor antagonism. It shows efficacy against the positive and negative symptoms of schizophrenic psychoses and other psychotic conditions, and has a low propensity to cause extrapyramidal side effects. The aim of these case reports in elderly patients is to provide the benefit of personal experience with risperidone to the body of published literature and to demonstrate the types of patients that may benefit from treatment. These cases were compiled retrospectively from data collected on referral and during routine hospital appointments. This series covers four main areas of concern when treating the elderly: low-maintenance dosing minimising the likelihood of adverse events; successful treatment of patients previously uncontrolled and experiencing side effects with other antipsychotics; the possibility of intermittent rather than continuous treatment; and the benefits to patients, carers and the health services. At low doses, risperidone is an effective and well-tolerated treatment for psychoses in elderly patients that improves the quality of life for both patients and their caregivers.

Tardive Dyskinesia: A Review

1995 ◽  
Vol 40 (7_suppl) ◽  
pp. 49-54 ◽  
Author(s):  
Paul R Latimer
Keyword(s):  
Clinical Practice ◽  
Tardive Dyskinesia ◽  
Antipsychotic Agent ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
Research Findings ◽  
Chronic Neuroleptic ◽  
Novel Antipsychotic ◽  
Iatrogenic Disorder ◽  
Typical Neuroleptics

Objective: To review recent research findings on tardive dyskinesia (TD) with relevance to clinical practice. Method: TD is a syndrome of involuntary movements that can occur in association with chronic neuroleptic use. It is of unknown pathophysiology. It can be irreversible, is cosmetically disfiguring, and can be functionally disabling. Results: There is as yet no treatment of demonstrated efficacy for TD. It is an iatrogenic disorder whose incidence is increased by age and total cumulative dose of typical neuroleptics. It has been the source of successful litigation in some jurisdictions but, until very recently, there has been no effective antipsychotic agent without this effect. Conclusion: This litigation in some jurisdictions has been a major impetus to the development of novel antipsychotic agents. It is less well known that a similar, possibly identical, movement disorder occurs spontaneously particularly in the elderly and inpatients with schizophrenia, and that TD is often reversible.

Delusional of Parasitosis in Geriatric Patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S470-S470
Author(s):  
M. Gutierrez Rodriguez ◽  
C. Moreno Menguiano ◽  
F. Garcia Sanchez ◽  
R. Martin Aragon
Keyword(s):  
Geriatric Patients ◽  
Current Knowledge ◽  
Case Reports ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
The Body ◽  
Delusional Parasitosis ◽  
Pubmed Database ◽  
Primary Disorder ◽  
Competing Interest

IntroductionDelusional of parasitosis or Ekbom's syndrome (ES) is a psychiatric disorder in which the patient has a fixed and false belief that small organisms infest the body. The belief is often accompanied by hallucinations. It is an uncommon condition that was initially studied by dermatologists, more prevalent in the elderly and typically observed in women older than 50 years although isolated cases among men have been reported.ObjectiveTo review current knowledge about delusional of parasitosis in elderly patients through literature systematic review and the analysis of a case report.MethodologyWe performed a literature search using electronic manuscripts available in PubMed database published during the last five years, following the description and discussion of a clinical case. We report a case of an 85-year-old man who presented a delusional parasitosis as a primary disorder.ResultsThe literature on ES consists mostly of case reports and limited series. In this paper, we analyze the etiology, demographic characteristics, clinical features and treatment in geriatric patients with delusional parasitosis.ConclusionInternational classifications have included this syndrome in non-schizophrenic delusions. However, it has also been reported in schizophrenia, affective disorders, and organic or induced psychosis. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Role of Atypical Antipsychotic Agents in the Treatment of Schizophrenia and Schizoaffective Disorders in the Elderly

2006 ◽  
Vol 1 (3) ◽  
pp. 227-241 ◽  
Author(s):  
Subramoniam Madhusoodanan ◽  
Abhishek Sinha ◽  
Martha Sajatovic ◽  
Sanjay Gupta ◽  
Ronald Brenner
Keyword(s):  
Atypical Antipsychotic ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
Schizoaffective Disorders ◽  
Atypical Antipsychotic Agents

Neuroleptics

2008 ◽  
Author(s):  
Deirdre Johnston
Keyword(s):  
Behavioral Problems ◽  
Meta Analysis ◽  
Antipsychotic Agents ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Behavioral Disturbances ◽  
Neurologic Diseases ◽  
Alternative Interventions ◽  
Conventional Antipsychotics ◽  
Increased Risk

The ‘‘neuroleptic’’ antipsychotic group of pharmacologic agents was so named because the original agents, now called ‘‘conventional’’ antipsychotics, produced significant neurologic side effects in the form of extrapyramidal symptoms (EPS). However, neuroleptics were the first drugs to be effective in treating psychosis and remain the cornerstone of pharmacologic management of psychotic symptoms, whether such symptoms are primary or arise in the context of neurologic disorders. Although the only U.S. Food and Drug Administration (FDA)–approved use of antipsychotic agents is for the treatment of schizophrenia, mania, and ‘‘psychosis,’’ there is strong agreement among dementia experts that both the conventional antipsychotics and the newer ‘‘atypical’’ agents have a place in the management of several behavioral symptoms in persons with dementia (Small et al., 1997). Concerns have been raised regarding increased risk of stroke and increased mortality in the elderly, and a recent meta-analysis found the use of both conventional and atypical antipsychotics in dementia to be associated with a small increased risk for death compared with placebo (Schneider, Dagerman, and Insel, 2005). When choosing an antipsychotic medication, these and other risks should be considered within the context of an individual patient’s medical need for the drug, medical comorbidity, and the efficacy and safety of alternatives. In psychiatric disorders complicating neurologic diseases, antipsychotic drugs are used to treat specific syndromes (mania, delusional depression, schizophrenia) and target symptoms (hallucinations, delusions, tics in Tourette’s syndrome, chorea in Huntington’s disease). They are also used to ameliorate severe agitation or other behavioral problems that threaten the safety of the patient or others and have not responded to alternative interventions. These indications for antipsychotic drug use are further detailed in the chapters on specific neurologic diseases. Antipsychotic medications should not be used for milder behavioral disturbances, such as the wandering, disinhibited social intrusiveness, or frustration-induced emotional lability seen in some patients with cognitive impairment. In these instances, nonpharmacologic methods such as environmental manipulation should be tried first. For example, gentle redirection of the patient, assistance with activities of daily living, a night light in the bedroom, structured schedules of activities, and caregiver education about such strategies may alleviate some problem behaviors.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

The effect of dental geriatric curricula on attitudes toward the elderly

1988 ◽  
Vol 52 (9) ◽  
pp. 516-518 ◽  
Author(s):  
J Mann ◽  
TJ Bomberg ◽  
JM Holtzman ◽  
DB Berkey
Keyword(s):  
The Elderly

Speech-Language Pathologists' Attitudes Toward Aging and the Elderly

2003 ◽  
Vol 30 (Fall) ◽  
pp. 146-155 ◽  
Author(s):  
Jeff Searl ◽  
Rodney M. Gabel
Keyword(s):  
The Elderly ◽  
Speech Language Pathologists ◽  
Attitudes Toward Aging

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

2015 ◽  
Vol 25 (2) ◽  
pp. 61-69
Author(s):  
Angel L. Ball ◽  
Adina S. Gray
Keyword(s):  
Depressive Symptoms ◽  
The Elderly ◽  
Environmental Communication ◽  
Pharmacological Intervention ◽  
Team Approach ◽  
Discussion Paper ◽  
Term Care ◽  
Anticholinergic Medications ◽  
Inappropriate Treatment ◽  
Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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