Comparison of psychotropic drug preferences and side effects in old and young patients with schizophrenia and schizoaffective disorder
Öz
Purpose: The current study investigates the preferred psychotropic drug treatments and their tolerability in elderly patients (EP) with a diagnosis of schizophrenia or schizoaffective disorder compared to younger patients (YP).
Materials and Methods: The study included 154 EP and 195 YP with schizophrenia/schizoaffective disorder admitted to the outpatient unit at a university hospital in the last decade. The medical records of the patients were reviewed. The types and doses of antipsychotic drugs used by each patient, use of other psychotropic drugs, ongoing complaints, drug-related side effects and compliance with treatment were also examined.
Results: Second generation antipsychotic use was higher in YP (88% in YP, 80% in EP). Antipsychotic equivalent doses were found 266.63 mg in EP, 522.21 mg in YP, that also higher in the YP group. The use of clozapine (7% in EP, 37% in YP) and mood stabilizers (4.5% in EP, 18% in YP) were higher in YP. There was a higher rate of dose reduction of antipsychotic drugs in EP (21.5% in YP, 52% in EP). When the groups were compared in terms of the reasons of antipsychotic dose reduction, it was more frequent in EP due to side effects (21.4% in YP, 40% in EP), while the dose reduction due to remission was more common in YP (78.6% in YP, 60% in EP) .
Conclusion: Lower doses of antipsychotics in EP suggests milder symptoms or lower tolerability. The higher clozapine and mood stabilizer use in YP can be explained by avoiding side effects like extrapyramidal, cardiovascular and metabolic side effects that are more frequent in EP.
Anahtar Kelimeler
Elderly, schizophrenia, schizoaffective disorder, antipsychotics, mood stabilizers
Kaynakça
- 1. Erol A, Kılıçaslan EE. Symptom pattern and clinical course in schizophrenia. In schizophrenia and other psychotic disorders (Eds Danacı AE Böke Ö, Saka MC, Erol A, Kaymak SU):13-29. Ankara, Turkish Psychiatric Association, 2018.
- 2. Lawrence RE, First MB. Psychopathology. In The american psychiatric association publishing textbook of schizophrenia second edition (Eds Lieberman JA, Stroup ST, Perkins DO, Dixon LB):35-52. Washington, 2020.
- 3. Ng B, Martinez S, Koh S, Tohen M, Gangwisch JE. Epidemiology. In The american psychiatric association publishing textbook of schizophrenia second edition (Eds Lieberman JA, Stroup ST, Perkins DO, Dixon LB):3-11. Washington, 2020.
- 4. Hjorthoj C, Sturup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4(4): 295-301.
- 5. Solomon HV, Sinopoli M, DeLisi LE. Ageing with schizophrenia: an update. Current Opinion in Psychiatry 2021; 34(3): 266-74.
- 6. Grundy EM, Murphy M. Population ageing in Europe. In Oxford Textbook of Geriatric Medicine (Eds Michel JP, Beattie BL, Martin FC, Walston JD):11-8. Oxford, 2017.
- 7. Cohen CI, Meesters PD, Zhao J. New perspectives on schizophrenia in later life: implications for treatment, policy, and research. Lancet Psychiatry 2015; 2(4): 340-50.
- 8. Binbay T, Ulas H, Elbi H, Alptekin K. The psychosis epidemiology in Turkey: A systematic review on prevalence estimates and admission rates. Turk Psikiyatri Dergisi 2011; 22(1).
- 9. Üçok A, Preventive treatments in schizophrenia and risk groups for psychosis. In schizophrenia and other psychotic disorders (Eds Danacı AE Böke Ö, Saka MC, Erol A, Kaymak SU):93-105. Ankara, Turkish Psychiatric Association, 2018.
- 10. Uchida H, Mamo DC. Dosing of antipsychotics in schizophrenia across the life-spectrum. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33(6): 917-20.
