Skip to main content
SpringerLink
Log in

Schizophrenia in the Elderly

Guidelines for Management

CNS Drugs Aims and scope Submit manuscript

Cite this article

Abstract

The treatment of schizophrenia in older populations poses special challenges for patients, family members and clinicians. These include changes in manifestation of schizophrenic illness in later life, age-related changes in response to pharmacological treatments and psychosocial issues associated with older life status.

As with younger individuals, antipsychotic medications constitute the mainstay of treatment for schizophrenia in the elderly. However, the drug treatment of schizophrenia is substantially affected by the aging process. Medication sensitivity is pronounced in the elderly, largely due to age-related changes in the body’s capacity to metabolise psychotropic and other drugs. Other relevant factors include higher rates of physical comorbidity, drug-drug interactions and age-related adverse effects. Generally, the appropriate starting dose of antipsychotic medication in the elderly is 25% of the adult dose. Total daily maintenance doses may be 30 to 50% of the adult dose.

The use of conventional antipsychotics in the elderly is limited because of their association with extrapyramidal symptoms and anticholinergic and cardiovascular adverse effects. The advent of atypical antipsychotics has revolutionised the treatment of psychosis in the elderly. Based on the general psychiatric literature, the atypical agents have been found to be as efficacious as conventional agents in reducing positive symptoms, more efficacious against negative symptoms, and to have a much more benign adverse effect profile.

Nonpharmacological issues in the management of schizophrenia in the elderly are at least as important as in younger individuals. Older individuals may face additional challenges that affect health outcome, such as living alone or being unable to drive. All drug treatments should be partnered with supportive approaches and psychosocial interventions that maximise treatment compliance and improve outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III
Table IV

Similar content being viewed by others

References

  1. Malmgren R. Epidemiology of aging. In: Coffey CE, Cummings JL, editors. Textbook of geriatric neuropsychiatry. Washington, DC: American Psychiatric Press, 1994; 17–33

    Google Scholar 

  2. Deamer RL, Thompson JF. The role of medications in geriatric sexual function. Clin Geriatr Med 1991; 7: 95–111

    PubMed  CAS  Google Scholar 

  3. Gurland BJ, Cross PS. Epidemiology of psychopathology in old age. Psychiatr Clin North Am 1982; 5: 11–26

    PubMed  CAS  Google Scholar 

  4. Ruskin PE. Schizophrenia and delusional disorders. Verwoerdt’s Clin Geropsychiatr 1990; 125–35

  5. Cohen CI. Outcome of schizophrenia into later life: an overview. Gerontologist 1990; 30: 790–7

    Article  PubMed  CAS  Google Scholar 

  6. Sajatovic M, Donenwirth K, Sultana D, et al. Age-related comparison of health resource utilization in women with serious mental illness [abstract]. Schizophr Res 1999; 36(1-3): 349

    Google Scholar 

  7. Belisky R, McGlashan TH. The manifestations of schizophrenia in late life: a dearth of data. Schizophr Bull 1993; 19: 683–5

    Article  Google Scholar 

  8. Davidson J, Harvey PD, Powchick P, et al. Severity of symptoms in chronically institutionalized geriatric schizophrenic patients. Am J Psychiatry 1995; 152: 2: 197–207

    Google Scholar 

  9. Kraepelin E. Dementia Praecox. In: Kraepelin E, Diefendorf AR, translators. Clinical psychiatry: a textbook for studentsand physicians. 6th ed. New York (NY): Macmillan Press, 1902

    Google Scholar 

  10. Jeste DJ. Late-life schizophrenia: editor’s introduction. SchizophrBull 1993; 19(4): 687–9

    Article  CAS  Google Scholar 

  11. Harris MJ, Jeste DV. Late-onset schizophrenia: an overview. Schizophr Bull 1988; 14: 39–55

    Article  PubMed  CAS  Google Scholar 

  12. Bleuler M. The schizophrenic disorders: long-term patient and family studies. New Haven (CT): Yale University Press, 1978

    Google Scholar 

  13. Ciompi L. Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophr Bull 1980; 6: 606–18

    Article  PubMed  CAS  Google Scholar 

  14. Huber G, Gross G, Schuttler R, et al. Longitudinal studies of schizophrenia patients. Schizophr Bull 1980; 6(4) 592–605

    Article  PubMed  CAS  Google Scholar 

  15. Ciompi L. Review of follow-up studies on long-term evolution and aging in schizophrenia. In: Miller NE, Cohen GD, editors. Schizophrenia and aging. New York (NY): Guilford Press, 1987

    Google Scholar 

  16. Tsuang M, Woolson R, Fleming J. Long-term, outcome of major psychosis. Schizophrenia and affective disorders compared with psychiatrically symptom free surgical conditions. Arch Gen Psychiatry 1979; 36: 1295–301

    CAS  Google Scholar 

  17. Harding DM, Brooks GW, Ashikaga T, et al. The Vermont longitudinal study of persons with severe mental illness. I. Methodology, study sample and overall status 32 years later. Am J Psychiatry 1987; 144: 718–26

    CAS  Google Scholar 

  18. McGlashan TH. A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophr Bull 1988; 14: 515–42

    Article  PubMed  CAS  Google Scholar 

  19. Pfohl B, Winokur G. The evolution of symptoms in institutionalized hebephrenic/catatonic schizophrenics. Br J Psychiatry 1982; 141: 567–72

    Article  PubMed  CAS  Google Scholar 

  20. Schulz SK, Miller DD, Oliver SE, et al. The life-course of schizophrenia: age and symptom dimensions. Schizophr Res 1997; 23: 15–23

    Article  Google Scholar 

  21. Seeman M. Current outcome in schizophrenia: women vs men. Acta Psychiatr Scand 1986: 73(6): 609–17

    Article  PubMed  CAS  Google Scholar 

  22. Riecher-Rossler A, Hafner H, Dutsch-Strobela A, et al. Further evidence for a specific role of estradiol in schizophrenia? Biol Psychiatry 1994; 36(7): 492–4

    Article  PubMed  CAS  Google Scholar 

  23. Powchik KP, Davidson M, Nemeroff CB, et al. Alzheimer-disease-related protein in geriatric schizophrenic patients with cognitive impairment. Am J Psychiatry 1993; 150: 1726–7

    PubMed  CAS  Google Scholar 

  24. Haroutunian V, Davidson M, Kanof PD, et al. Cortical cholinergic markers in schizophrenia. Schizophr Res 1994; 12: 137–44

    Article  PubMed  CAS  Google Scholar 

  25. Heaton R, Paulsen JS, McAdams LA, et al. Neuropsychological deficits in schizophrenics. Arch Gen Psychiatry 1994; 51: 469–76

    Article  PubMed  CAS  Google Scholar 

  26. Addington J, Addington D. Positive and negative symptoms of schizophrenia: their course and relationship over time. Schizophr Res 1991; 5: 51–9

    Article  PubMed  CAS  Google Scholar 

  27. American Psychiatric Association. DSM-III. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association, 1980

    Google Scholar 

  28. American Psychiatric Association. DSM-III-R. Diagnostic and statistical manual of mental disorders. 3rd rev. ed. Washington, DC: American Psychiatric Association, 1987

    Google Scholar 

  29. American Psychiatric Association DSM-IV. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994

    Google Scholar 

  30. Tran-Johnson TK, Krull AJ, Jeste DV. Late-life schizophrenia and its treatment: pharmacologic issues in older schizophrenia patients. Clin GeriatrMed 1992; 8(2): 401–10

    CAS  Google Scholar 

  31. World Health Organization. International classification of diseases. 10th rev. Geneva: World Health Organization, 1992

    Google Scholar 

  32. Jeste DV, Harris MJ, Pearlson GD, et al. Late-onset schizophrenia: studying clinical validity. Psychiatr Clin North Am 1988; 11: 1–14

    PubMed  CAS  Google Scholar 

  33. Almeida OP, Howard RJ, Levy R, et al. Psychotic states arisingin late life (late paraphrenia). The role of risk factors. Br J Psychiatry 1995; 166: 215–28

    CAS  Google Scholar 

  34. Devane CL. Principles of pharmacokinetics and pharmacodynamics. In: Schatzberg AF, Nemeroff CB, editors. The American Psychiatric Press textbook of psychopharmacology. 2nd ed. Washington, DC: American Psychiatric Press Inc., 1998

    Google Scholar 

  35. von Moltke LL, Greenblatt DJ, Harmatz JS, et al. Psychotropic drug metabolism in old age principles and problems of assessment. In: Bloom FE, David J, editors. Fourth generation of progress. New York (NY): Kupfer Raven Press Ltd, 1995

    Google Scholar 

  36. Greenblatt DJ, Sellers EM, Shader RI. Drug disposition in old age. N Engl J Med 1982; 306: 1081–8

    Article  PubMed  CAS  Google Scholar 

  37. Salzman C. Geriatric Psychopharmacology. Ann Rev Med 1985; 36: 217–28

    Article  PubMed  CAS  Google Scholar 

  38. Gierz M, Jeste DV. Physical comorbidity in elderly veteransaffairs patients with schizophrenia and depression. Am J Geriatr Psychiatry 1993; 1(2): 165–70

    Article  Google Scholar 

  39. Lazare A. Medical disorders in psychiatric populations, In: Lazare A, editor. Outpatientpsychiatry: diagnosis and treatment. Baltimore (MD): Williams and Wilkins, 1989; 240–5

    Google Scholar 

  40. Jeste DV, Gladsjo JA, Lindamer LA, et al. Medical comorbidity in schizophrenia. Schizophr Bull 1996; 22: 413–30

    Article  PubMed  CAS  Google Scholar 

  41. Simpson JC, Tsuang MT. Mortality among patients with schizophrenia. Schizophr Bull 1996; 22: 485–99

    Article  PubMed  CAS  Google Scholar 

  42. Harris EC, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry 1998; 173: 11–54

    Article  PubMed  CAS  Google Scholar 

  43. deLeon J, Dadvand M, Canuso C, et al. Schizophrenia and smoking: an epidemiologic survey in a state hospital. Am J Psychiatry 1995; 152: 453–5

    CAS  Google Scholar 

  44. Weickert-Shannon C, Kleinman JE. The neuroanatomy and neurochemistryof schizophrenia. Psychiatr Clin North Am 1998;21(1): 57–76

    Article  Google Scholar 

  45. Targum SD, Abbott JL. Psychosis in the elderly: a spectrum of disorders. J Clin Psychiatry 1999; 60(8 Suppl.): 4–10

    PubMed  Google Scholar 

  46. Waddington JL, Youssef HA, Kinsella A. Mortality in schizophrenia: antipsychotic polypharmacy and absence of adjunctiveanticholinergics over the course of a 10-year prospective study. Br J Psychiatry 1998; 173: 325–9

    Article  PubMed  CAS  Google Scholar 

  47. Kane JM. Tardive dyskinesia: epidemiological and clinical presentation. In: Bloom FE, Kupfer DJ, editors. Psychopharmacology: the fourth generation of progress. New York (NY): Raven Press, Ltd, 1995

    Google Scholar 

  48. Morgenstern H, Glazer WM. Identifying risk factors for tardive dyskinesia among long-term outpatients maintained with neuroleptic medications. Results of the Yale and tardive dyskinesia study. Arch Gen Psychiatry 1993; 50: 723–33

    CAS  Google Scholar 

  49. Hoffman WF, Ballard L, Turner EH, et al. Three-year follow-up of older schizophrenics: extrapyramidal syndromes, psychiatric symptoms, and ventricular brain ratio. Biol Psychiatry 1991; 30(9): 913–26

    Article  PubMed  CAS  Google Scholar 

  50. Saltz BL, Woerner MG, Kane JM, et al. Prospective study of tardive dyskinesia incidence in the elderly. JAMA 1991; 266: 2402–6

    Article  PubMed  CAS  Google Scholar 

  51. Jeste DV, Caligiuri MP, Paulsen JS, et al. Risk of tardive dyskinesia in older patients: a prospective longitudinal study of 266 patients. Arch Gen Psychiatry 1995; 52: 756–65

    Article  PubMed  CAS  Google Scholar 

  52. Woerner MG, Alvir JMJ, Saltz BL, et al, Prospective study of tardive dyskinesia in the elderly. Am J Psychiatry 1998; 155: 1521–8

    PubMed  CAS  Google Scholar 

  53. Jeste DV, Lacro JP, Palmer B. Incidence of tardive dyskinesia in early stages of low-dose treatment with typical neuroleptics in older patients. Am J Psychiatry 1999; 256: 309–11

    Google Scholar 

  54. Waddington JL, Youssef HA. Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dipkinesia. Psychol Med 1996; 26(4): 681–8

    Article  PubMed  CAS  Google Scholar 

  55. Jeste DV, Lacro JP, Gilbert PL, et al. Treatment of late-life schizophrenia with neuroleptics. SchizophrBull 1993; 19: 817–30

    Article  CAS  Google Scholar 

  56. Owens DGC, Johnstone EC, Frith CD. Spontaneous involuntary disorders of movement: their prevalence, severity and distribution in chronic schizophrenics with and without treatment with neuroleptics. Arch Gen Psychiatry 1982; 39: 452–61

    Article  PubMed  CAS  Google Scholar 

  57. Brecher M. Follow up study of risperidone in the treatment of patients with dementia: interim results on tardive dyskinesia and dyskinesia severity [abstract no. NR 342]. In: Winstead DK, Skodol AE, Chairpersons. New research program and abstracts. American Psychiatric Association Annual Meeting: 1998 May 30–Jun 4; Toronto, Ontario. Washington, DC: American Psychiatric Association, 1998

    Google Scholar 

  58. Kuntz AJ, Reams SG, Sanger TM, et al. Olanzapine in the treatment of elderly patients with schizophrenia and related psychotic disorders. American Association of Geriatric Psychiatry Annual Meeting: 1998 Mar 9–11; San Diego

  59. Lieberman JA, Saltz BL, Johns CA, et al. The effects of clozapine on tardive dyskinesia. Br J Psychiatry 1991; 158: 503–10

    Article  PubMed  CAS  Google Scholar 

  60. Alvir JMJ, Lieberman JA, Safferman AZ, et al. Clozapineinduced agranulocytosis: incidence and risk factors in the United States. N Engl J Med 1993; 329(3): 162–7

    Article  PubMed  CAS  Google Scholar 

  61. Sussman N, Ginsberg D. Effects of psychotropic drugs on weight. Psychiatric Annals 1999; 29(10): 580–94

    Google Scholar 

  62. Bandelow B, Fritze J, Ruther E. Increased mortality in schizophrenia and the possible influence of antipsychotic treatment. Int J Psych Clin Pract 1998; 2: S49–S57

    CAS  Google Scholar 

  63. Barnes TRE, McPhillips MA. Critical analysis and comparison of the side-effect and safety profiles of the new antipsychotics. Br J Psychiatry 1999; 174: 34–43

    Google Scholar 

  64. Goff DC, Baldessarini RJ. Drug interactions with antipsychotic agents. J Clin Psychopharmacol 1993; 13: 57–65

    Article  PubMed  CAS  Google Scholar 

  65. Taylor D, Lader M. Cytochromes and psychotropic drug interactions. Br J Psychiatry 1996; 168: 529–32

    Article  PubMed  CAS  Google Scholar 

  66. Buckley P, Larkin C, O’Callaghan E. Psychosis following useof proprietary antidiarrhoeal medicines. Br J Psychiatry 1990;157: 758–9

    Article  PubMed  CAS  Google Scholar 

  67. Centorrino R, Baldessarini RJ, Frankenburg FR. Serum levels of clozapine and nonclozapine in patients treated with selective serotonin reuptake inhibitors. Am J Psychiatry 1996; 153:820–2

    PubMed  CAS  Google Scholar 

  68. Fuller M, Sajatovic M. Drug information handbook for psychiatry.1st ed. Cleveland (OH): Lexi-Comp, Inc., 1999

    Google Scholar 

  69. American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 1997; 154(4 Suppl.): 1–63

    Google Scholar 

  70. Raskind M, Elvarey C, Herlin RN. Fluphenazine enanthate in the treatment of late paraphrenia. J Am Geriatr Soc 1979; 27: 459–63

    PubMed  CAS  Google Scholar 

  71. Howard R, Levy R. Which factors affect treatment response in late paraphrenia? International response in late paraphrenia? Int J Geriatr Psychiatry 1992; 7: 667–72

    Article  Google Scholar 

  72. McEvoy JP, Mccue M, Spring B, et al. Effects of amantadine and trihexyphenidyl on memory in elderly normal volunteers. Am J Psychiatry 1987: 144: 573–7

    PubMed  CAS  Google Scholar 

  73. Bymaster FP, Calligaro DO, Falcone JF, et al. Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology 1996; 14(2): 87–96

    Article  PubMed  CAS  Google Scholar 

  74. Schotte A, Janssen PF, Gommeren W, et al. Risperidone compared with new and reference antipsychotic drugs: in vitro and in vivo receptor binding. Psychopharmacology (Berl.) 1996; 124(1-2): 57–73

    Article  CAS  Google Scholar 

  75. Kumar V. Use of atypical agents in geriatric patients: a review. Int J Geriatr Psychopharmacology 1997; 1: 15–23

    CAS  Google Scholar 

  76. Pickar D. Prospects for pharmacotherapy of schizophrenia. Lancet 1995; 345(8949): 557–62

    Article  PubMed  CAS  Google Scholar 

  77. Physician’s desk reference. 53rd ed. Montvale (NJ): Medical Economics Company, 1999

  78. Howanitz E, Pardo M, Smelson DA, et al. The efficacy and safety of clozapine versus chlorpromazine in geriatric schizophrenia. J Clin Psychiatry 1999; 60: 41–4

    Article  PubMed  CAS  Google Scholar 

  79. Chengappa KN, Baker RW, Kreinbrook SB, et al. Clozapine use in female geriatric patients with psychosis. J Geriatr Psychiatry Neurol 1995; 8: 12–5

    PubMed  CAS  Google Scholar 

  80. Frankenburg FR, Kalunian D. Clozapine in the elderly. J Geriatr Psychiatry Neurol 1994; 7: 129–32

    PubMed  CAS  Google Scholar 

  81. Salzman C, Vaccaro B, Lieff J, et al. Clozapine in older patients with psychosis and behavior disruption. Am J Geriatr Psychiatry 1995; 3: 26–33

    Google Scholar 

  82. Sajatovic M, Jaskiw G, Konicki PE, et al. Outcome of clozapine therapy for elderly patients with refractory primary psychosis. Int J Geriatr Psychiatry 1997; 12: 553–8

    Article  PubMed  CAS  Google Scholar 

  83. Pitner JK, Mintzer JE, Pennypacker LC, et al. Efficacy and adverse effects of clozapine in four elderly psychotic patients. J Clin Psychiatry 1995; 56: 180–5

    PubMed  CAS  Google Scholar 

  84. Richards SS, Sweet RA, Ganguli R, et al. Clozapine: acute and maintenance treatment in late life psychosis [abstract]. Am J Geriatr Psychiatry 1996; 4: 377–8

    Google Scholar 

  85. Sajatovic M, Ramirez LF, Garver D, et al. Clozapine therapy for older veterans. Psychiatric Services 1998; 49(3): 340–4

    PubMed  CAS  Google Scholar 

  86. Overall JE, Gorham D. The brief psychiatric rating scale. Psychologic Rep 1962; 10: 799–812

    Article  Google Scholar 

  87. Meltzer HY, Okayli G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact of risk-benefit assessment. Am J Psychiatry 1995; 152: 183–90

    PubMed  CAS  Google Scholar 

  88. Zayas EM, Grossberg GT. The treatment of psychosis in late life. J Clin Psychiatry 1998; 59(1 Suppl.): 5–10

    PubMed  Google Scholar 

  89. Abernathy DR. Psychotropic drugs and the aging process: pharmacokinetics and pharmacodynamics. In: Salzman C, editor. Clin Geriatr Psychopharmacol. 2nd ed. Baltimore (MD): Williams and Wilkins, 1992

    Google Scholar 

  90. Madhusoodanan S, Brenner R, Araujo L, et al. Efficacy of risperidone treatment for psychosis associated with schizophrenia, schizoaffective disorder, bipolar disorder or senile dementia in 11 geriatric patients: a case series. J Clin Psychiatry 1995; 56: 514–8

    PubMed  CAS  Google Scholar 

  91. Sajatovic M, Ramirez LF, Vernon L, et al. Outcome of risperi done therapy in elderly patients with chronic psychosis. Int J Psychiatry Med 1996; 26: 309–17

    Article  PubMed  CAS  Google Scholar 

  92. Zarate Jr CA, Baldessarini RJ, Seigel AT, et al. Risperidone in the elderly: a pharmaco-epidemiologic study. J Clin Psychiatry 1997; 58: 311–7

    Article  PubMed  CAS  Google Scholar 

  93. Madhusoodanan S, Suresh P, Brenner R, et al. Experience with the atypical antipsychotics—risperidone and olanzapine in the elderly. Ann Clin Psychiatry 1999; 11(3): 113–8

    PubMed  CAS  Google Scholar 

  94. Reyntjens A, Heylen S, Gelders Y, et al. Risperidone in the treatment of behavioral symptoms in psychogeriatric patients: a pilot clinical investigation [abstract]. Psychopharmacology 1988; 96 Suppl. 1: 335

    Google Scholar 

  95. Jeste DV, Eastham JH, Lacro JP, et al. Management of late-life psychosis. J Clin Psychiatry 1996; 57 Suppl. 3: 39–45

    Google Scholar 

  96. Berman I, Merson A, Sison C, et al. Regional blood flow changes associated with risperidone treatment in elderly schizophrenic patients: a pilot study. Psychopharmacol Bull 1996; 32:95–100

    PubMed  CAS  Google Scholar 

  97. Madhusoodanan S, Brecher M, Brenner R, et al. Risperidone in the treatment of elderly patients with psychotic disorders. Am J Geriatr Psychiatry 1999; 7: 132–8

    PubMed  CAS  Google Scholar 

  98. Kay R, Fiszbein A, Opler I. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bull 1987; 13: 261–76

    Article  CAS  Google Scholar 

  99. Chouinard G, Ross-Chouinard A, Annabel I, et al. The extrapyramidal symptoms rating scale [abstract]. Can J Neurol Sci 1980: 7: 233

    Google Scholar 

  100. Berman I, Merson A, Allan F, et al. Effect of risperidone oncognitive performance in elderly schizophrenic patients: a double blind comparison study with haloperidol [abstract]. Psychopharmacol Bull 1995; 31: 552

    Google Scholar 

  101. Jeste DV, Lacro JP, Nguyen HA, et al. Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in older patients. J Am Geriatr Soc 1999; 47(6): 716–9

    PubMed  CAS  Google Scholar 

  102. Satterlee WG, Reams SG, Burns PR, et al. A clinical update on olanzapine treatment in schizophrenia and in elderly Alzheimer’s disease patients [abstract]. Psychopharmacol Bull 1995; 31: 534

    Google Scholar 

  103. Madhusoodanan S, Brenner R, Suresh P, et al. Efficacy and tolerability of olanzapine in elderly patients with psychotic disorders: a prospective study. Ann Clin Psychiatry. In press

  104. Sajatovic M, Perez D, Brescan D, et al. Olanzapine therapy in elderly patients with schizophrenia. Psychopharmacol Bull 1998; 34(4): 819–23

    PubMed  CAS  Google Scholar 

  105. Berman I, Bayog RD, Wu C, et al. Cognitive effect of olanzapine [abstract no. NR 532]. In: Winstead DK, Skodol AE, Chairpersons. New research program and abstracts. American Psychiatric Association Annual Meeting: 1998 May 30–Jun 4; Toronto, Ontario. Washington, DC: American Psychiatric Association, 1998

    Google Scholar 

  106. McManus DQ, Arvanitis LA, Kowalcyk BB. Quetiapine, a novel antipsychotic: experience in elderly patients with psychotic disorders. J Clin Psychiatry 1999; 60: 292–8

    Article  PubMed  CAS  Google Scholar 

  107. Guy W. ECDEU assessment manual for psychopathology. Pub(ADM) 76-338. Rockville (MD): National Institute of Mental Health, 1976

    Google Scholar 

  108. Seeger TE, Seymour PA, Schmidt AW, et al. Ziprasidone (CP-88, 059)a new antipsychotic with combined dopamine andserotonin receptor antagonist activity. J Pharmacol Exp Ther 1995; 275: 101–13

    PubMed  CAS  Google Scholar 

  109. Tandon R, Harrigan E, Zorn SH. Ziprasidone: a novel antipsychotic with unique pharmacology and therapeutic potential. JSerotonin Res 1997; 4: 159–77

    Google Scholar 

  110. Fein S. Treatment of drug refractory schizophrenia. Psychiatr Ann 1998; 28: 215–9

    Google Scholar 

  111. Palmer BW, Heaton SC, Jeste DV. Older patients with schizophrenia:challenges in the coming decades. Psychiatr Serv 1999; 50(9): 1178–83

    PubMed  CAS  Google Scholar 

  112. Patterson TL, Jeste DV. The potential impact of the baby-boomgeneration on substance abuse among elderly persons. PsychiatrServ 199; 50(9): 1184-8

  113. Lehman AF. Public health policy, community services, and outcomesfor patients with schizophrenia. Psychiatr Clin NorthAm 1998; 21(1): 221–31

    Article  CAS  Google Scholar 

  114. Lacro JP, Jeste DV. Geriatric psychosis. Psychiatr Q 1997; 68(3): 247–60

    Article  PubMed  CAS  Google Scholar 

  115. Lamy PP, Salzman C, Nevis-Olesen J. Drug prescribing patterns, risks and compliance guidelines. In: Salzman C, editor. Clinical geriatric psychopharmacology. 2. Baltimore (MD): Williams and Wilkins, 1992

    Google Scholar 

Download references

Acknowledgements

The authors are grateful for the support of Northcoast Behavioral Healthcare System and for the secretarial assistance of Mrs Pamela Burton.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Case Western Reserve University, USA

    Martha Sajatovic & Peter Buckley

  2. Northcoast Behavioral Healthcare, Cleveland Campus, 1708 Southpoint Drive, Cleveland, Ohio, 44109, USA

    Martha Sajatovic & Peter Buckley

  3. Department of Psychiatry, State University of New York, Health Science Center at Brooklyn, New York, USA

    Subramoniam Madhusoodanan

  4. St John’s Episcopal Hospital, Far Rockaway, New York, USA

    Subramoniam Madhusoodanan

Authors
  1. Martha Sajatovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Subramoniam Madhusoodanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Buckley
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sajatovic, M., Madhusoodanan, S. & Buckley, P. Schizophrenia in the Elderly. Mol Diag Ther 13, 103–115 (2000). https://doi.org/10.2165/00023210-200013020-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00023210-200013020-00004

Keywords

search

Navigation