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[Delirious states in elderly persons. Therapeutic modalities].
1Département de médecine et de gérontologie, CH de Courbevoie-Neuilly, 30, av. Kilford, 92401 Courbevoie. mp.pancrazi@wanadoo.fr
Presse Medicale (Paris, France : 1983)
|July 15, 2003
Summary
Treating late-life psychosis requires addressing the cause and behavioral issues. Management strategies differ for long-term versus new-onset delusions in older adults, prioritizing non-pharmacological and atypical antipsychotic approaches.
Area of Science:
- Geriatric Psychiatry
- Neuroscience
- Pharmacology
Context:
- Psychosis in late life presents unique challenges, influenced by etiology and behavioral symptoms like agitation.
- Distinguishing between chronic psychosis and new-onset delusions after age 60 is crucial for effective management.
- Emotional and delusional disorders frequently co-occur in the elderly population.
Purpose:
- To outline current therapeutic trends for psychosis in older adults.
- To differentiate treatment strategies for established versus late-onset delusions.
- To provide guidance on non-pharmacological and pharmacological interventions.
Summary:
- Treatment for established psychosis may involve dose reduction and switching to atypical neuroleptics for better tolerance.
- Late-life delusions require etiology-specific treatment, considering dementia, schizophrenia, or vascular causes.
- Therapeutic approaches integrate non-pharmacological methods (psychotherapy, environmental adjustments) and pharmacological agents (atypical antipsychotics, antidepressants, anti-epileptics).
- For dementia with cholinergic deficiency, cholinesterase inhibitors show efficacy in managing hallucinations.
Impact:
- Informs clinical practice for managing psychosis in the elderly.
- Highlights the importance of personalized treatment strategies based on underlying causes.
- Emphasizes a multimodal approach combining behavioral and pharmacological interventions for improved patient outcomes.