Therapeutic targets in late-life psychoses: review of concepts and critical issues.
Psychoses in late life are a diagnostic challenge because of disagreement over how these entities should be classified. The main diagnostic categories of late-life psychoses include dementia with psychotic symptoms, late-onset schizophrenia, delusional disorder, early-onset psychotic disorders extending through late life, late-onset mood disorders, psychotic disorders caused by medical conditions or medications, and delirium. First onset of psychotic symptoms in late life is commonly associated with identifiable structural brain abnormalities and reflects underlying brain pathology. We reviewed the available literature on late-life psychotic manifestations, focusing on diagnostic classification and treatment approaches. Antipsychotics are the mainstay of treatment for these conditions, but should be used cautiously in elderly patients because of their increased sensitivity to side effects. Overall, appropriate research data on the effectiveness of various antipsychotic agents for late-life psychotic conditions are lacking. Non-antipsychotic psychotropic medications may be of value in managing some of these conditions.
Soares
J C
JC
Department of Psychiatry, University of Pittsburgh School of Medicine 15213, USA.
Gershon
S
S
D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000188:drug therapy; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D009626:Terminology as Topic
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors