Posted by ed_uk on December 5, 2005, at 15:21:29
In reply to Re: Older Antipsychotic Drugs Called Risky, posted by med_empowered on December 3, 2005, at 16:43:03
In healthy elderly people, 'generalised anxiety' can be treated with SSRIs such as citalopram. Low dose of benzodiazepines can be used as a short-term treatment for severe anxiety and insomnia associated with physical disease, hospital admission etc. Short-acting benzos such as oxazepam and temazepam may be safer for elderly people - they are less likely to accumulate and to be associated with falls and confusion.
In elderly patients who suffer from dementia, paranoid delusions and severe agitation are common. Very low doses of risperidone can sometimes provide symptomatic relief eg. 0.25mg to 1.5mg/day in divided doses.
Risperidone appears to be the most appropriate pharmacological treatment for paranoid delusions and hallucinations in patients with dementia. Benzodiazepines tend to worsen confusion, frequently inducing delirium. Haloperidol was commonly used in the past eg. 0.5mg every 12 hours prn. Risperidone appears to be more effective and better tolerated than haloperidol.
Antipsychotics should never be used to control 'challenging behavior' in elderly people. In patients with demential, APs should only be used to treat distressing hallucinations, delusions and severe agitation.
Ed
poster:ed_uk
thread:584836
URL: http://www.dr-bob.org/babble/20051203/msgs/585789.html