No good quality research to guide the treatment of late-onset schizophrenia

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Late-onset schizophrenia is relatively common. Onset after the age of 40 years is reported in 23% of patients hospitalised with schizophrenia.

The condition is different from early-onset schizophrenia on a number of counts, including the response to antipsychotic drugs.

This Cochrane review set out to assess the effects of antipsychotic drugs for elderly people with late-onset schizophrenia.

The original version of this review was based on a literature search carried out in 2002. That search retrieved no trials that compared antipsychotic drugs with other treatments for elderly people (at least 80% older than 65 years) with a recent (within five years) diagnosis of schizophrenia or schizophrenia like illnesses.

This time around the reviewers carried out a comprehensive and systematic search, but still only found 1 study that they could include in their review, which provided little usable data.

The authors concluded:

There is no trial-based evidence upon which to base guidelines for the treatment of late-onset schizophrenia. There is a need for good quality-controlled clinical trials into the effects of antipsychotics for this group. Such trials are possible. Until they are undertaken, people with late-onset schizophrenia will be treated by doctors using clinical judgement and habit to guide prescribing.

Essali A, Ali G. Antipsychotic drug treatment for elderly people with late-onset schizophrenia. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD004162. DOI: 10.1002/14651858.CD004162.pub2.

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Andre Tomlin

Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol with his wife, dog and three little elflings.

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