Journal ArticleDOI
Antipsychotic treatment in elderly patients on polypharmacy with schizophrenia
TLDR
In this paper , the authors report that antipsychotic treatment reduces overall mortality, hospitalization, and cardiovascular death in the elderly with schizophrenia. But, the authors do not consider the use of polypharmacy.Abstract:
Purpose of review Elderly patients with schizophrenia (SCH) are treated with antipsychotics and are often on different comedications, including polypharmacy (five or more medications). Evidence-based guidelines and randomized controlled trials do not include patients on polypharmacy, something that represents a ‘gap’ between evidence-based recommendations and clinical prescribing patterns. In this context, narrative reviews are needed to help clinicians in daily practice. Recent findings Antipsychotic treatment efficacies in meta-analyses are similar in the elderly with SCH compared with the general population (medium effect size). Long-term cohort studies show that antipsychotic treatment reduces overall mortality, hospitalizations, and cardiovascular death. These studies are limited because polypharmacy was not studied. The prevalence of antipsychotic use as potentially inappropriate medications was very high in nursing homes (25%). The prevalence of antipsychotic polypharmacy was 40%. Different strategies to manage these problems are available, including collaboration with clinical pharmacists, leading to reduced polypharmacy and better adherence to treatment guidelines. Summary Elderly patients with SCH on polypharmacy are less frequently studied, although they represent many patients with SCH. Different potentially inappropriate medication lists and collaboration with clinical pharmacists represent effective strategies for medication optimization. More studies are needed on this topic (e.g., prospective nonrandomized studies). read more
Citations
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Journal ArticleDOI
Polypharmacy Management of Antipsychotics in Patients with Schizophrenia
TL;DR: A review of the application of antipsychotic polypharmacy (APP) in clinical practice is presented in this article , which discusses the merits of APP, matters that need to be considered, and a switch from APP to APM.
Journal ArticleDOI
Editorial: The mental health in post-COVID-19 era: challenges and consequences
T. M. Glebova,Gavin Van Horn +1 more
TL;DR: The authors Correspondence to Mohan Isaac, University of Western Australia, Faculty of Health and Medical Sciences, Perth, WA 6009, Australia. E-mail: [email protected]
Journal ArticleDOI
Deep Clinical Phenotyping of Schizophrenia Spectrum Disorders Using Data-Driven Methods: Marching towards Precision Psychiatry
Tesfa Dejenie Habtewold,Jiasi Hao,Edith J. Liemburg,Nalan Bastürk,Richard Bruggeman,Behrooz Z. Alizadeh +5 more
TL;DR: In this paper , the authors provided an overview of findings from the Genetic Risk and Outcome of Psychosis (GROUP) cohort study on the deep clinical phenotyping of schizophrenia spectrum disorders targeting positive and negative symptoms, cognitive impairments and psychosocial functioning.
References
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Journal ArticleDOI
Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis
Stefan Leucht,Andrea Cipriani,Andrea Cipriani,Loukia M. Spineli,Dimitris Mavridis,Deniz Örey,Franziska Richter,Myrto Samara,Corrado Barbui,Rolf R. Engel,John R. Geddes,Werner Kissling,Marko Paul Stapf,Bettina Lässig,Georgia Salanti,John M. Davis +15 more
TL;DR: A Bayesian-framework, multiple-treatments meta-analysis of randomised controlled trials to compare 15 antipsychotic drugs and placebo in the acute treatment of schizophrenia found all drugs were significantly more effective than placebo.
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Clinical consequences of polypharmacy in elderly
TL;DR: It is shown that well-designed interprofessional intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes.
Journal ArticleDOI
Use of Prescription and Over-the-counter Medications and Dietary Supplements Among Older Adults in the United States
Dima M. Qato,G. Caleb Alexander,G. Caleb Alexander,Rena M. Conti,Michael Johnson,Phil Schumm,Stacy Tessler Lindau +6 more
TL;DR: In this sample of community-dwelling older adults, prescription and nonprescription medications were commonly used together, with nearly 1 in 25 individuals potentially at risk for a major drug-drug interaction.
Journal ArticleDOI
Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study
Alessandro Nobili,Giuseppe Licata,Francesco Salerno,Luca Pasina,Mauro Tettamanti,Carlotta Franchi,Luigi De Vittorio,Alessandra Marengoni,Salvatore Corrao,Alfonso Iorio,Maura Marcucci,Pier Mannuccio Mannucci +11 more
TL;DR: Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome, however, AEs were strongly correlated with a longer hospital stay and higher mortality risk.
Journal ArticleDOI
Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study
Sylke Andreas,Holger Schulz,Jana Volkert,Maria Christina Dehoust,Susanne Sehner,Anna Suling,Berta Ausín,Alessandra Canuto,Mike J. Crawford,Chiara Da Ronch,Luigi Grassi,Yael Hershkovitz,Manuel Muñoz,Alan Quirk,Ora Rotenstein,Ana Belén Santos-Olmo,Arieh Y. Shalev,Jens Strehle,Kerstin Weber,Karl Wegscheider,Hans-Ulrich Wittchen,Martin Härter +21 more
TL;DR: The findings underscore the need for improving diagnostic assessments adapted to the cognitive capacity of elderly people and to deliver high-quality mental health services to these individuals.