Citation

Aftab A, Shah AA. Psychiatr. Clin. North Am. 2017; 40(3): 449-462.

Affiliation

Psychiatric Residency Education, Menninger Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Menninger Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive Suite 600, Houston, TX 77098, USA; Mood Disorder Research Program at BT, Neuropsychiatric Center, Ben Taub Hospital/HHS, Room 2.125, 1502 Taub Loop, Houston, TX 77030, USA; Community Behavioral Health Program, Psychotherapy Services, Neuropsychiatric Center, Ben Taub Hospital/HHS, Room 2.125, 1502 Taub Loop, Houston, TX 77030, USA.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.psc.2017.05.010

PMID

28800801

Abstract

This article reviews psychiatric considerations and common psychiatric emergencies in the elderly. The elderly are vulnerable to medication side-effects because of pharmacokinetic changes from aging, and require lower doses and slower titration. They are a high-risk group for suicide, with more serious intent, fewer warning signs, and more lethality. Prompt diagnosis and treatment of delirium in emergency settings is essential, given association with worse outcomes when undiagnosed. Pharmacologic options with demonstrable efficacy for agitation in dementia are limited to antipsychotics, which are, however, associated with an increased risk of mortality; behavioral interventions are universally recommended as first-line measures.

Copyright © 2017 Elsevier Inc. All rights reserved.

Language: en

Keywords

Agitation; Delirium; Dementia; Emergency psychiatry; Geriatric psychiatry; Suicide