Expert Consensus Guidelines™ - Using Antipsychotic Agents in Older Patients

Using Antipsychotic Agents in Older Patients

Alexopoulos GS, Streim J, Carpenter D,. Docherty JP. The Expert Consensus Guidelines™: Using Antipsychotic Agents in Older Patients. J Clin Psychiatry 2004;65(suppl 2):1-105

Antipsychotics are widely used in geriatric psychiatric disorders. A growing number of atypical antipsychotics are available, expanding clinical options but complicating decision-making. Many questions about the use of antipsychotics in older patients remain unanswered by available clinical literature. We therefore surveyed expert opinion on antipsychotic use in older patients (65 years of age or older) for recommendations concerning indications of antipsychotics, choice of antipsychotics for different conditions (e.g., delirium, dementia, schizophrenia, delusional disorder, psychotic mood disorders) and for patients with comorbid conditions or history of side effects, dosing strategies, duration of treatment and medication combinations. A written survey with 47 questions and 1,411 options was sent to 52 national experts, 48 (92%) of whom completed it. The results of this survey were used to develop a set of user-friendly guidelines that cover 1) indications for using antipsychotics in older patients, 2) selection of specific antipsychotics for different indications, 3) duration of treatment, 2) selecting antipsychotics for patients with complicating conditions, 4) considerations about drug-drug interactions and side effects in antipsychotic selection.

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