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Advances in Psychiatric Treatment (2005) 11: 286-296
© 2005 The Royal College of Psychiatrists

Treatment of psychosis in elderly people

Salman Karim and Eleanor J. Byrne

Salman Karim is a lecturer in old age psychiatry at University of Manchester (Division of Psychiatry, Education and Research Centre, Wythenshawe Hospital, Manchester M23 9LT, UK. Tel: 0161 291 5867/5884; fax: 0161 291 5882; e-mail: skarim{at}fs1.with.man.ac.uk). His special interests are schizophrenia in elderly people and the role of inflammation in the aetiology of Alzheimer’s disease. Eleanor Byrne is a senior lecturer in old age psychiatry at the University of Manchester with a special interest in dementia with Lewy bodies.

Psychotic symptoms in elderly people can be seen in a variety of conditions. This article reviews treatment strategies (both pharmacological and non-pharmacological) for such symptoms in schizophrenia and neurodegenerative disorders in this population. Traditionally, antipsychotics have been the most commonly used treatment for psychotic symptoms. Their usefulness in treating schizophrenia, both chronic and late onset, is well established and the atypical antipsychotics, which have a better side-effect profile, are more suitable for elderly people. More recently, there have been increasing concerns about their safety in psychoses due to dementia. The debate about whether an absolute ban on their use is required is still ongoing, but it has highlighted the need for adopting and developing non-pharmacological interventions.




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