Antipsychotic drug treatment for elderly people with late-onset schizophrenia

Abstract

There is no trial-based evidence upon which to base guidelines for the treatment of late onset schizophrenia. This review highlights the need for good quality controlled clinical trials to address the effects of antipsychotic drugs for this group. Such trials are possible. Until they are undertaken people with late onset schizophrenia will be treated by doctors using clinical judgement and habit to guide prescribing.

Elderly Patients with Schizophrenia and Depression: Diagnosis and Treatment

“…In addition, Arunpongpaisal et al (85) reviewed studies examining atypical antipsychotics with other treatments for elderly patients who had a recent diagnosis (within five years) of schizophrenia, delusional disorder, schizoaffective disorder, schizophreniform psychosis or paraphrenia. They stated there is no trial-based evidence upon which to base guidelines for the treatment of late-onset schizophrenia.…”

Predictors of adherence to atypical antipsychotics (risperidone or olanzapine) in older patients with schizophrenia: an open study of 3½ years duration

“…The evidence base for the use of antipsychotics in older people with schizophrenia is small and generally of low quality (Arunpongpaisal et al, 2003;Jeste et al, 2005). The evidence that does exist though suggests that atypical antipsychotics may be of particular benefit in managing this patient group (Ritchie, 2005).…”

Change in antipsychotic usage pattern and risk of relapse in older patients with schizophrenia

“…The recommendations on the use of antipsychotics in the older patients are primarily based on studies including younger patients (Marriott et al, 2006). In addition, there is no trial-based evidence for guidelines on medication in late-onset schizophrenia (Arunpongpaisal et al, 2003;Suzuki et al, 2011;Essali and Ali, 2012). Despite the shortage of studies, SGAs, after their introduction, have been widely recommended as a treatment of choice for older psychotic patients instead of FGAs, mainly because of a better side-effect profile (Alexopoulos et al, 2004).…”