title: Acute neuroleptic treatment in elderly patients without dementia.
abstract: Low doses of neuroleptics are the standard for treating psychosis in elderly patients because of concern about inducing adverse effects. The authors found that fixed, low-dose neuroleptic treatment (0.15 mg/kg/day) for 10 days resulted in low perphenazine levels and low rates of acute response (25%) in elderly patients with primary psychotic illness (without dementia). Increase in initial dose did not speed acute response and induced adverse effects that were absent or minimal with low-dose treatment. With higher-dose treatment, drug blood levels rose disproportionately, and level-to-dose ratios were higher than those observed in non-elderly adults. Naturalistic follow-up suggested that response may take longer to develop than in non-elderly adults and that low doses for a longer duration may provide effective treatment.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Mazure
authors.forename: J C
authors.initials: JC
authors.lastname: Nelson
authors.forename: P I
authors.initials: PI
authors.lastname: Jatlow
authors.forename: M B
authors.initials: MB
authors.lastname: Bowers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004351:Drug Resistance; D004409:Dyskinesia, Drug-Induced; D005260:Female; D005500:Follow-Up Studies; D005852:Geriatric Psychiatry / Q000379:methods; D006801:Humans; D008297:Male; D010546:Perphenazine / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D010546:Perphenazine