Vascular psychosis in the elderly. case report and literature review for different antypsichotic treatment strategies

• Published in: European psychiatry 2021-04, Vol.64 (S1), p.S744-S745
• Main Authors: Higueras, T. Gutiérrez, De La Cuesta Alonso, S. Sainz, Cortés, F. Calera, Forés, S. Vicent
• Format: Article
• Language: English
• Subjects: Abstract; Antipsychotics; Case reports; Dementia; E-Poster Viewing; Elderly; Literature reviews; Older people; Psychosis; Psychotropic drugs; Treatment; vascular
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1192/j.eurpsy.2021.1973

IntroductionThe most common cause of vascular psychosis is cerebrovascular disease. Tipically a late-onset in the elderly is accompanied with multiple strokes (disruption of blood flow to the brain). Dementia is a clinical syndrome characterised by cognitive, neuropsychiatric, and functional symptoms. About neuropsychiatric symptoms there are multiple warnings concerning the use of antipsychotics in people with dementia due to an increased risk of death and stroke.ObjectivesPresentation of a case of vascular psychosis with a literature review of antipsychotic drugs used in these cases.MethodsWe carried out a literature review in Pubmed electing those articles focused on antipsychotic treatment options.ResultsA 81-year-old man was taken by his son seeking medical assistance due delusions of reference and auditory hallucinations. He believed that his family wanted to kill him. He had the sensation about how multiple voices were telling him about to scape from people who wanted to kill him. After a completelly study and CT, chronic microvascular infarctions where found. After onset of non effective treatment with haloperidol 1.5 mg during 1 week, we switched into risperidone 1.5mg. Effective treatment was found and now patient is under control of sypmtoms.ConclusionsDifferent antypsichotic treatments are described in the literature. Risperidone, quetiapine and olanzapine were found as most used antipsychotic for psychosis in vascular dementia. Comparision of side effect profile of antipsychotic and effectiviness must be the target for an adecuate treatment.DisclosureNo significant relationships.