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12 - Pharmacological treatment of psychosis and depression in neurological disease in older adults

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Mark Rapoport ,
Cara Brown  and
Craig Ritchie
Edited by
Peter Tyrer  and
Kenneth R. Silk
Mark Rapoport
Affiliation:
University of Toronto Sunnybrook Health Sciences Centre Toronto ON Canada
Cara Brown
Affiliation:
University of Toronto Toronto ON Canada
Craig Ritchie
Affiliation:
Department of Mental Health Sciences Royal Free and University Medical School Hampstead Campus Hampstead London UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editors' note

Conventional diagnostic descriptions are not satisfactory for many late life disorders in which multiple pathology is common. This chapter examines two frequent clinical syndromes, psychotic and depressive disorders, in those who have significant neurological disorders; mainly dementia, parkinsonism, cerebrovascular disease and traumatic brain injury. It will be noted that the evidence base and recommendations for treatment are often very different in the presence of other pathologies, and that there are many important gaps in our knowledge. The reader will also be reminded that dosage of drugs is crucial in this population and often differs from the equivalent conditions in adult psychiatry.

Introduction

Many neurological diseases have an increased incidence in old age. Alzheimer's disease (AD) is present in 8% of the Canadian population over the age of 65 (Lindsay et al., 2004), and this prevalence will climb as the population ages in the decades to come, since the prevalence of AD doubles every 5 years up to the age of 85 (United States General Accounting Office, 1998). Stroke is a major leading cause of death and disability for older adults. The prevalence of Parkinson's disease (PD) and Parkinsonian symptoms increase dramatically with age (Bennett et al., 1996; Van Den Eeden et al., 2003). Traumatic brain injury (TBI) is generally more common in younger adults, in whom it is often associated with alcohol or substance misuse.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 244 - 262
Publisher: Cambridge University Press
Print publication year: 2008

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