Antipsychotic medication and the elderly

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Introduction In recent years, the use of antipsychotics (AP) has been widely debated for reasons concerning their efficacy and safety in the elderly. Objectives We aimed to assess the prescription of AP in the elderly subjects. Methods We led a retrospective and descriptive study. We extracted all patients aged 65 years or older who consulted the psychiatric outpatient unit at the Hedi Chaker hospital in Sfax –Tunisia between January 1 and December 31 2019 and who were treated with AP. General, clinical and therapeutic data were collected from medical records. Results The mean age of patients was 71,7 years. Medical conditions were observed in 53,1% of them. The reasons for consultation were behavioral disturbances (34,4%), insomnia (18,8%) and memory impairment (15,6%). The main retained diagnoses were dementia (40,6%), mood disorders (28,1%), delusional disorder (15,6%). The indications for prescribing antipsychotics were disruptive behavior (59,4%) and delirium/hallucinations (34,4%). Laboratory examinations and electrocardiogram were performed respectively in 46,8% and 15,6% of cases. AP treatment was prescribed in 90,6% of cases right from the first consultation. Atypical AP were prescribed in 56,2% of cases. Adverse effects were noted in 18,7% of patients. The average time to get a response was 7.3 weeks Conclusions The use of AP in the elderly requires an individual assessment, case by case; particular caution is recommended. Conflict of interest No significant relationships.

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