Updates in Geriatric Psychiatry-view presentation

Video Transcription

Video Summary

In the video, Dr. Susan Lehman discusses psychotic disorders in late life. She provides an overview of the prevalence of psychotic symptoms among older adults, the appropriate workup for new onset psychosis, and the differentiation between psychosis associated with dementia and that associated with primary psychiatric illness. She also discusses the risks of using antipsychotics in older adults and the approach to pharmacotherapy and psychosocial treatments for schizophrenia in late life.<br /><br />Dr. Lehman emphasizes the importance of a comprehensive and thorough diagnostic evaluation, including obtaining a detailed history, conducting a physical and neurological examination, and ordering laboratory tests. She also highlights the need to consider the role of medications and substances in causing or exacerbating psychotic symptoms.<br /><br />Regarding treatment, Dr. Lehman recommends starting with low doses of antipsychotic medications and gradually titrating up based on response and tolerability. She discusses the efficacy and side effects of different antipsychotic medications, including clozapine, risperidone, olanzapine, quetiapine, sulpiride, and aripiprazole. She also mentions the potential benefits of psychosocial treatments, such as assertive community treatment and skills training.<br /><br />Dr. Lehman stresses the importance of informed consent and ongoing monitoring of symptoms and side effects. She also highlights the role of electroconvulsive therapy (ECT) in treating psychotic symptoms, particularly in cases of medication resistance or intolerable side effects.<br /><br />Overall, the video provides useful information on the evaluation and management of psychotic disorders in late life.

Keywords

psychotic disorders

late life

prevalence

psychotic symptoms

older adults

antipsychotics

pharmacotherapy

psychosocial treatments

evaluation