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Episode 135: Antipsychotics – use in the elderly – part 4

In episode 135, Mike and James and Adil finally get to the end of their antipsychotic tetralogy as they tackle the especially difficult issue of the use of antipsychotics in the elderly. The problem is non-pharmacological treatments do very little, and one is left with having to decide whether or not to use drugs. We discuss the evidence of effectiveness (or lack thereof) of these drugs and the very real potential for harm. At the end, Adil makes both Mike and James agitated and he sedates them with a high dose of a very fine cognac. 

Show notes

1) Non-pharmacological interventions

Aging Ment Health 2009;13:512-20

2) Use of antipsychotics for psychosis of dementia

Int J Geriatr Psychiatry 2007;22:475-84

Psychother Psychosom 2007;76:213-8

Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003476. 

3) Adverse effects of the antipsychotics

JAMA 2005;294:1934-43

NEJM 2005;353:2335-41

Ann Intern Med 2007;146:775-86

4) DART-AD study – effect of stopping antipsychotics

Lancet Neurol 2009;8:151–7

PLoS Med 5(4):e76.doi:10.1371/journal.pmed.0050076

5) Tools for practice

What are the Risks and Benefits of Stopping Antipsychotics in the Elderly?

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