Schizophrenia Spectrum Illness in Later Life

Question 1

What features of schizophrenia spectrum illness are more likely in later life?

Answer 1

• Visual/auditory/tactile hallucination more common
• More common third person running commentary
• More common accusatory hallucinations
• Partition (delusion that things can pass through walls)
• Phantom boarder
• Persecutory delusions
• Organic causes more common

Question 2

In treating late-onset schizophrenia with drugs, what special considerations are pertinent?

Answer 2

• EPS - more likely with D2 blockers e.g. risperidone, olanzapine
• Orthostatic hypotension (falls) - a1 blockers e.g. the above and clozapine
• Metabolic adverse effects - especially olazapine, clozapine