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Home » Topics » Geriatric Psychiatry

Geriatric Psychiatry
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Research Update

Stimulating the Precuneus May Slow Alzheimer’s Decline

February 23, 2026
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Research Update Edited by Carlat Staff

Can brain stimulation help preserve function in Alzheimer’s disease? A year-long randomized trial suggests that PC- rTMS modestly slows cognitive and functional decline, offering a potential nonpharmacologic adjunct as clinicians seek alternatives to long-term medication burden.



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Fact Sheet

Donepezil (Aricept, Adlarity) Fact Sheet [G]

January 1, 2026
Talia Puzantian, PharmD, BCPP and Daniel Carlat, MD

Dr. Carlat and Dr. Puzantian have no financial relationships with companies related to this material.
Full Fact Sheet Editorial Information

Donepezil is the cholinesterase inhibitor with the longest track record and with which we have the most experience. It is generally considered the first-line agent for dementia. Though not a cure, it delays dementia progression by six to 12 months.


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Fact Sheet

Galantamine (Razadyne, Razadyne ER) Fact Sheet [G]

January 1, 2026
Talia Puzantian, PharmD, BCPP and Daniel Carlat, MD

Dr. Carlat and Dr. Puzantian have no financial relationships with companies related to this material.
Full Fact Sheet Editorial Information

Galantamine has no appreciable benefit over donepezil; however, its availability in a liquid formulation is helpful for patients who have difficulty swallowing pills.


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Clinical Update

Prescribing Antipsychotics for Neuropsychiatric Symptoms in Dementia

January 1, 2026
Julia Cromwell, MD
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Julia Cromwell, MD. Medical director and geriatric and adult inpatient psychiatrist, Mass General Brigham Salem Hospital, Salem, MA.

Dr. Cromwell has no financial relationships with companies related to this material. 

Antipsychotics can reduce severe agitation or psychosis in dementia but at significant cost. Learn when to use them.


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Expert Q&A

Clinical Pearls for Hyperbolic Tapering of Psychiatric Medications in Older Adults

January 1, 2026
Mark Horowitz, MBBS, PhD
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Mark Horowitz, MBBS, PhD

Clinical Research Fellow, North East London NHS Foundation Trust; Lecturer in Psychopharmacology (Visiting), King’s College, London, UK; Co-founder and consultant for Outro Health; Co-author of Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs. 

Dr. Horowitz has no financial relationships with companies related to this material.

Stopping psychiatric medications can be harder than starting them. Dr. Mark Horowitz explains why withdrawal happens, how hyperbolic tapers work, and how to deprescribe safely while maintaining stability and trust.


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Clinical Update

Behavioral Strategies for Apathy and Late-Life Depression

January 1, 2026
Jaime A.B. Wilson, PhD, ABN
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Jaime A.B. Wilson, PhD, ABN, ABPP, MSCP. Prescribing medical psychologist and board-certified neuropsychologist in private practice, Tacoma, WA.

Dr. Wilson has no financial relationships with companies related to this material.

Not all late-life low mood requires medication. This article explores how apathy differs from depression and how behavioral activation, microgoals, and lifestyle interventions can restore motivation, improve cognition, and reduce unnecessary antidepressant exposure in older adults.


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Expert Q&A

Using Lithium in Older Adults With Chronic Kidney Disease

January 1, 2026
Michael Gitlin, MD
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Michael Gitlin, MD

Distinguished Professor of Clinical Psychiatry; Director, Mood Disorders Clinic, Geffen School of Medicine, Los Angeles, CA.

Dr. Gitlin has no financial relationships with companies related to this material.

Lithium remains a powerful mood stabilizer in late life, but aging kidneys change the equation. Dr. Michael Gitlin reviews kidney-conscious dosing, monitoring by eGFR, and shared decision-making strategies to balance lithium’s benefits against renal risk in older adults.


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Research Update

Olive Oil Linked to Lower Dementia Mortality

January 1, 2026
Jaime A.B. Wilson, PhD, ABN
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Jaime A.B. Wilson, PhD, ABN, ABPP, MSCP. Dr. Wilson has no financial relationships with companies related to this material. 


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Fact Sheet

Major Neurocognitive Disorder: Medication Treatment

January 1, 2026
Victoria Hendrick, MD and Daniel Carlat, MD

Dr. Carlat and Dr. Puzantian have no financial relationships with companies related to this material.
Full Fact Sheet Editorial Information

There is no cure for major neurocognitive disorder (MND), but several medications mitigate the progression of cognitive and functional decline.


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Fact Sheet

Memantine (Namenda, Namenda XR) Fact Sheet [G]

January 1, 2026
Talia Puzantian, PharmD, BCPP and Daniel Carlat, MD

Dr. Carlat and Dr. Puzantian have no financial relationships with companies related to this material.
Full Fact Sheet Editorial Information

Memantine’s indication (moderate to severe dementia only) may limit its use, but it does boast a unique mechanism of action and has some data to support its usefulness as an augmenter of donepezil.


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