Geriatric Psychiatry

Research Update

A Timely Look at Community Reinforcement for Seniors With Unhealthy Alcohol Use

Topics: Alcohol | Alcohol use disorder | Geriatric Psychiatry | Motivational Interviewing | Psychotherapy

Review of: Andersen K et al, Addiction 2020;115(1):69–81 During the COVID-19 pandemic, when every personal contact requires risk-reward deliberations, understanding the impact of relationships on health is crucial. This timely study, conducted from 2014 through 2016, investigated whether social networks reduce drinking among older adults with alcoh

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Clinical Update

Is Ramelteon an Effective Hypnotic?

Topics: Belsomra | Benzodiazepines | Geriatric Psychiatry | Hypnotics | Lemborexant | Melatonin | Sleep | Suvorexant

Ramelteon (Rozerem) stands out from other hypnotics in several ways: It is not a controlled substance and has no risk of addiction or ­withdrawal. It is relatively safe in the elderly. It has a low risk of falls and complex sleep behaviors. However, ramelteon’s use has been limited by its high cost and modest efficacy. Now that it’s gone ge

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Clinical Update

Nuplazid: Novel Mechanism, Modest Benefits

Topics: Dopamine | Geriatric Psychiatry | Neurology | Novel Medications | Nuplazid | Parkinson’s

Psychosis can be a paralyzing dilemma for patients with Parkinson’s disease (PD). Most antipsychotics worsen the motor symptoms of PD, while the dopaminergic drugs that treat PD can worsen the psychosis. Psychosis afflicts up to 60% of patients with PD, and it is the leading cause of nursing home placement in these patients (Hacksell U et al, Neuroche

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Research Update

Antipsychotics Fall Short in Delirium

Topics: Dopamine | Geriatric Psychiatry | Neurology | Novel Medications | Nuplazid | Parkinson’s

Review: Oh ES et al, Ann Intern Med 2019;171(7):474–484; Nikooie R et al, Ann Intern Med 2019;171(7):485–495 Study type: Systematic reviews of randomized controlled trials and prospective studies Delirium is common and costly. With an incidence rate approaching 50% in hospitalized older adults, the condition poses a burden that is anticipated

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Research Update

Lithium in Geriatric Depression

Topics: Depression | Depressive Disorder | Geriatric Psychiatry | Lithium | Psychopharmacology | Treatment-Resistant Depression

REVIEW OF: Buspavanich P et al, J ­Affect Disord 2019;251:136–140 TYPE OF STUDY: Prospective, non-randomized controlled trial Augmentation with lithium has long been established as an effective strategy for refractory depression, but how does it fare in geriatric patients? There is a dearth of evidence on lithium in the geriatric population, which

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Article

The Aging Brain: Preventing Cognitive Decline

Topics: Cognitive Decline | Dementia | Geriatric Psychiatry

We’ve all been there. A 63-year-old patient comes to you with a chief complaint of memory loss. She tells you that she has a hard time remembering people’s names and forgets where she puts her keys. She lives and drives on her own without a problem, but asks, “Isn’t there some memory pill I can take?” What advice can we give her? The first

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Article Links

Screening Tests for Cognitive Decline

Topics: Cognitive Decline | Dementia | Geriatric Psychiatry

Screening tests can also help distinguish normal aging from a Neurocognitive Disorder. The popular Mini Mental Status Exam is being replaced by more sensitive tests like the Montreal Cognitive Assessment (MOCA) and the Saint Louis University Mental Status Examination (SLUMS). Both of these can be completed in 10 minutes and are normed for Mild and Major

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Research Update

Moderate Alcohol Use Associated With Reduced Risk of Dementia

Topics: Alcohol Use | Dementia | Geriatric Psychiatry | Research Update

Review of: Sabia S et al, BMJ 2018;362:k2927 Type of study: Prospective cohort study Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients. What about the cumulative impact of alcohol over one’s lifet

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