[Neuroleptics in psychogeriatrics. Evaluation of a treatment proposal]

Based on the receptor-binding profiles and a number of pharmacokinetic considerations, five neuroleptic drugs (haloperidol, bromperidol, pipamperone, zuclopenthixol and droperidol) were selected for use in different clinical situations in a psychogeriatric nursing home of 250 patients in 1984. In December 1988 an evaluation of this policy showed that on average 31% of the nursing home population were prescribed maintenance therapy of neuroleptic medication. When comparing the group of patients on neuroleptic medication with the total population no difference could be demonstrated in sex, age or psychiatric diagnosis, but there was a difference with respect to the three levels of disability. Psychosis and behavioural disturbances diminished to a manageable level in 69% of the patients. Drowsiness, orthostatic hypotension and anticholinergic effects were either not or not more often observed than in a group of control patients. Parkinsonism was observed more often, but not accompanied with a worse mobility or a higher falling rate. The treatment schedule utilized proved to be effective and safe.